Conversations can be a struggle when you’re not sure what to say or how to engage someone living with a cognitive illness. People can become so worried about making the individual feel bad or themselves uncomfortable that they often tend to avoid visiting the person altogether. But there is good news. By remembering that the most important action is not to isolate someone with cognitive disease, your determination to make this experience a positive one can make all the difference.
There are steps you can take but the first is understanding that cognitive impairment greatly affects communication. Realizing that there is nothing the person with Alzheimer’s or dementia can do to change the outcome can help your perspective and encourage your efforts to find ways to create a meaningful interaction.
You may notice they have difficulty finding the right words, repeat familiar words or describe objects instead of using their name. They might also lose their train of thought easily, struggle to logically organize their words, revert back to speaking a native language if they’re bilingual, speak less often and use gestures more than words
The behaviors you might see and how you can respond will depend on the stage of the disease. If your loved one is in a memory care community, the staff can be a lifeline to reach out to for suggestions and support. The Alzheimer’s Association also provides these tips for making conversing easier
In the early stages
The person will most likely be able to carry on a conversation, although you may notice they are beginning to repeat their stories or may struggle to find the right words when talking.
How to make conversations easier
- Don’t assume what their ability might be to carry on a conversation. Be a good listener and then adjust your response.
- Don’t exclude the person from conversations.
- Speak directly to the person and not through the caregiver.
- Be patient. Listen well and try to understand what they would like to express.
- Allow them time to respond and don’t interrupt.
- Ask the person directly if they need help.
- Ask them how they like to converse best, such as face-to-face, email or telephone calls.
- Remember that humor can make communication easier by lightening the mood.
In the middle stages
Typically the longest stage of the illness, there will be many changes during this time. As the disease progresses, communication becomes more difficult.
How to make conversations easier
- Find a quiet space where you can have a one-on-one conversation.
- Speak slowly and clearly.
- Make and maintain eye contact as it reflects you’re interested in what they’re saying.
- Don’t rush their response. Give them time to think about what they’d like to say.
- Be patient and reassuring when they speak
- Ask one question at a time. It’s easier to answer yes or no questions instead of open-ended ones.
- Don’t correct a mistake but instead listen carefully to find what they’re trying to say.
- Don’t argue with them, even if you disagree with what they say.
- Offer simple and short step-by-step instructions for tasks.
In the late stages
As this stage continues on, the individual may eventually no longer use words but rely on nonverbal communication, including facial expressions or other sounds to express themselves.
How to make conversations easier
- Approach the person from the front and identify yourself in order not to startle them.
- If you don’t understand what they’re trying to say, ask them to point or gesture.
- Try using touch, sights, sounds, smells and tastes as other forms of communication.
- Don’t lose the feelings behind the words. Try to discover what they want to convey.
- Always treat the person with dignity and respect. Never talk down or treat them as if they aren’t there.
- If you don’t know what to say, remember your presence is still important.
Communication between two people don’t have to involve speaking
If your loved one struggles with words or responds uncomfortably when you try to have a conversation, find ways to communicate without words. Hold their hand, listen to music, sing them a song or sit and browse through a memory book or old photo albums. Mention any memories you might have about the photos and share a good laugh if possible. If they are receptive to touch, this can bridge the emotion you both feel. A light touch on the shoulder or holding their hand while you talk can convey your kindness.
Even though it may make you uncomfortable at first, sitting quietly with someone and making eye contact can be a powerful way to speak directly to them. When you smile, the message can travel one step further. Even if the words are hard to come by, make sure you don’t abandon someone with Alzheimer’s or dementia. They may not be able to express their feelings back to you in words, but they can still feel the warmth and caring that your visit means.
Ingleside’s Memory Support Assisted Living
We know the communication challenges those with dementia and their families face. At Ingleside, we can help you better understand why this is happening, as well as support you and your loved one by offering tips to help you find your way when words may no longer be available. At Ingleside’s Memory Support Assisted Living, we understand the behavior and are trained to help you respond in a way that still conveys how much you care.