How to talk to people with dementia: 15 tips for communicating

The group of diseases and disorders known as dementias are one of the biggest challenges that medicine is facing today. With an increasingly aging population, the prevalence of this type of disorder is increasing over time, with more and more cases coming to the clinic.

Psychologists and neuropsychologists, as well as any other type of professional within the field of health or even at a social-care level, must Therefore, be properly prepared to deal with this type of patient, taking into account the possible difficulties that may come introduce.

Among them we can find a basic aspect that can make interaction very difficult, both to evaluate their capacities to carry out different therapies that help maintain and enhance their abilities as much as possible: the communication. That is why in this article we are going to mention a series of small aspects to take into account when talking with patients with advanced dementia.

• Related article: "https://psicologiaymente.com/clinica/tipos-demencias"

Briefly recalling the concept of dementia

We understand dementia as a type of disorder characterized by the presence of loss or deterioration of one or several mental faculties. whose alteration generates difficulties in daily life or a decrease in the quality of life of the subject (causing a limitation before non-existent). Usually it is about progressive and irreversible deterioration, although there are some that are treatable or in some cases even have a complete recovery (such as those caused by infections).

This deterioration is generally due to organic causes, although in some cases the exact reason for its appearance is unknown (if Although neurochemical and structural alterations that generate or participate in the symptoms are known, not because they happen). The evolution can be highly variable in each case, although the trend is towards a progressive or staggered deterioration in most cases.

• You may be interested in: "Non-pharmacological treatment of dementia: does it work?"

How to talk to a person with dementia

There are a large number of different dementias, which can affect different abilities. In many cases it ends up presenting a deterioration in the ability to attend to, remember, retain, or even understand and processing what is said to them can make it difficult to treat and even evaluate them. That is why we offer below a series of indications that may be useful when treating a patient with these characteristics.

1. speak clearly and vocally

A main aspect when communicating with a patient with dementia is the fact that be willing to adjust to the person's needs. Our tone must adjust to what the person needs and it must be possible to understand what we are expressing. Vocalizing is essential.

2. Short phrases, slow pace

Using excessively complex structures will make it difficult for the patient to understand. It is necessary to use a vocabulary adjusted to the patient's capacity (and to her knowledge and level of studies) and the shorter and clearer sentences the better. Avoid ambiguities, and use a slower pace.

3. repeat things

Whether there are problems encoding new information, retaining it, or simply paying attention, it can be difficult for a person with a more or less advanced dementia to capture from the first moment what is requests. Repeating the instructions may be more than necessary depending on the case.

4. Make sure that he has understood what you are saying

Linked to the above, it is essential to ensure that the patient has understood what is requested. This should be done in such a way that the patient does not feel ridiculed or bad for requiring new explanations.

And it is necessary to take into account that many people, even if they maintain sufficient capacities, pretend to have understood what that they are told out of shame or social desirability, and this is something that is actually hindering communication efficient.

5. Tolerate the frustration and do not get upset

The fact that a person does not understand what we want to say, does not achieve an improvement or that an efficient communication channel between patient and therapist cannot be found can be frustrating. Dealing with this type of patient may require a certain dose of patience, in addition to taking into account that the patient is not doing it on purpose.

6. without reproaches

It may seem obvious, but often the environment or even some professionals (especially those not specialized in this sector) tends to reproach in one way or another for forgetfulness or loss of faculties. The person does not forget things because they do or because they do not value what is said to them: they are being affected by a disorder that you cannot control and that causes you to be unable to store information.

Likewise, especially in the initial periods of dementia, patients are usually aware of the presence of deficits. Reproaching them will only increase their discomfort and anguish at the deterioration they have already perceived.

7. Avoid distractors

It can be difficult for a person with dementia to stay focused. That is why it is recommended that communication attempts be carried out in a context in which there are as few possible distractions as possible. A crowded office or a radio on for example they can easily cause you to lose the thread.

8. Find ways to communicate

It is not uncommon for serious problems to communicate orally to appear. Likewise, in advanced stages, people with dementia can become mute, unable to follow a conversation due to losing concentration or even remain in a state of absence. It is important to try to find a way to communicate, as socialization is important and can be reassuring.

If oral language does not work, perhaps gestures and mime can be used, or photos or drawings representing various concepts. They can also serve songs that are relevant to them. If they lose concentration, a touch or a little squeeze on their hand can help keep them on track a little more.

9. Start the interaction

Although it may be interesting to let the patient take the first step in communicating, the truth is that it can be difficult for them. Many dementias end up affecting the ability to motivate action and interaction, which will generally be more efficient that it be the professional who tries to establish the interaction and direct it.

10. Better indications or specific choices than general proposals

This is a small mistake that some people make and that can alter the performance and performance of the person in the task that is requested or the question that is asked. Making general proposals first of all makes you have to imagine and generate answers, as well as having to process the idea of ​​whether you should do it or not. This implies a much greater effort, as well as higher probability of confusion.

If we want him to carry out an action, it is important to indicate what he is expected to do, in a concrete way. Telling someone to raise a hand is not the same as asking if she could raise it. In the first case, you can do it, while in the second it can be interpreted as a mere question to be answered. Also, perhaps decision-making is one of the impaired skills. It can be useful to value it, but you have to take into account what you are seeing at any given moment.a hand.the abilities to tell you to do something.

11. Try to use positive phrases

It's good use instructions and phrases that express what the patient does or should do positive, avoiding the use of negations that are more complex to understand.

12. give it time

Sometimes something that is interpreted as a lack of memory or reasoning ability can actually be a problem with processing speed. By this we mean that we do not have to rush and jump from one thing to another, but rather that we have to give the patient a reasonable amount of time. in order to process the information and/or express.

13. The position, an important element

Another aspect to take into account when talking to a patient with dementia is the place or space that we occupy. We must stand in front of the person, facing him and relatively close, in such a way that our person captures her attention and has greater facility to observe our gesture language and hear our voice.

14. Do not rush to identify everything as a symptom of dementia

We must bear in mind that it is not uncommon for people with dementia or simply elderly people advanced have hearing problems, something that in turn must be assessed when examining a patient in order not to confuse a sensory problem with symptoms of dementia. Likewise, it is necessary to previously assess whether or not they have been educated, this also being something relevant in terms of adjusting the tests and treatments to their needs.

15. Always take him into account and treat him as an adult and dignified person

A person with dementia is still an adult. The treatment towards her You must always respect your dignity and you must be treated with respect..

Even if the person is not aware of where they are or who they are with, they should be treated as adults and not infantilized. Likewise, they should not be talked about as if they were not present, even if they do not show any reaction to stimulation or language.