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15 Tips for Communicating with Alzheimer’s Patients or Loved Ones

Nursing homeA person with Alzheimer’s disease often becomes confused and has difficulty communicating. He or she may struggle to find the right words to express him or herself, or may forget the meaning of words and phrases. The person also may rely on gestures, especially as his or her verbal skills decline.

Home care that is focused on the patient and aligned with that individual’s choices must include communication between the individual living with the disease and his or her entire care team. Despite the challenges, you can learn to communicate more effectively with a loved one or client who has Alzheimer’s disease.

There are several strategies you can use to improve communication. In addition to what is said, remember the importance of non-verbal communication. The presence, touch, gestures, and attention of caregivers can help to communicate acceptance, reassurance, and love to a person with Alzheimer’s disease. In all cases, treat the patient with dignity and respect.

15 Tips for communicating with a mid-stage (or later) Alzheimer’s patients or loved ones 

  1. Make eye contact. Always approach them from the front, face-to-face. Approaching and speaking from the side or from behind can startle them. It is vital that they actually see you and that their attention is focused on you. Read their eyes.
  2. Be at their level. Move your head, bend your knees or sit down to reach their level. Do not stand or hover over them. That can be intimidating and scary. They can’t focus on you and what you are saying if they are focused on their fear.
  3. Introduce yourself by name. Address the person by the name he or she prefers when appropriate.
  4. Speak slowly at about one half of your normal speed. Take a breath between each sentence. Allow more time for the person to process information and to respond to a question.
  5. Increase the use of gestures and other non-verbal communication, as needed. Observe the person and try to recognize what they are saying without words. Focus on the person’s feelings, not the facts. Sometimes gestures or other visual cues promote better understanding than words alone. For example, rather than simply asking if your loved one needs to use the toilet, take him or her to the toilet and point to it.
  6. Avoid interrupting. A person with dementia may lose their train of thought. Avoid criticizing, hurrying and correcting.
  7. Allow them to interrupt you, or they may forget what they want to say.
  8. Tell them what you are going to do before you do it, particularly if you are going to touch them. They need to know what is coming so that they don’t think that you are grabbing them.
  9. Speak calmly with an upbeat tone of voice, even if you don’t feel that way. If you sound angry or agitated, they will often mirror that feeling back to you. Even when you’re frustrated, try to keep your voice gentle. Your nonverbal cues, including the tone of your voice, can send a clearer message than what you actually say.
  10. Speak in short sentences. Speak in short direct sentences with only one idea to a sentence. Usually Alzheimer’s patients can only focus on only one idea at a time.
  11. Only ask one question at a time. Let them answer it before you  ask another question. You can ask who, what, where and when, but NOT why. Why is too complicated. They will try to answer, fail and get frustrated. Break down requests into single steps.
  12. Don’t say “remember.” Many times they will not be able to do so, and you are just pointing out to them their shortcomings. That is insulting, and can cause anger and/or embarrassment.
  13. Turn negatives into positives. For example, say “Let’s go here” instead of “Don’t go there.” Be inclusive and don’t talk down to them as if they were a child. Respect the fact that they are an adult, and treat them as such.
  14. Do not argue. It gets you nowhere. Instead, validate feelings, by saying, “I see that you are angry (sad, upset, etc…).” It lets them know that they are not alone and then redirects them into another thought. For example “It sounds like you miss your mother (husband, father, etc…). You love them very much, don’t you? Tell me about the time…” Then ask for one of their favorite stories about that person.
  15. Avoid distractions. Communication may be difficult — if not impossible — against a background of competing sights and sounds.

The Language of Behavior 

All behaviors, including reactions to daily care, are a form of communication. Most persons with Alzheimer’s will show symptoms related to behavior. Early on, they might have a hard time concentrating and experience irritability, anxiety or depression. Later in the disease, other symptoms may occur, including: sleep disturbances, outbursts, emotional distress, paranoia, delusions or hallucinations. These behaviors and the emotional state of patients with dementia are forms of communication used because they cannot make their needs known in other ways. For example, a person may resist getting dressed because of joint pain due to arthritis, but he or she cannot express this discomfort in words.

Communicating with your loved one or client may be challenging, especially as the disease progresses. Remember, however, the person isn’t acting this way on purpose. Don’t take it personally. Use patience and understanding to help sufferers of Alzheimer’s disease feel safe and secure.

To “Increase Your Understanding of Alzheimer’s Disease,” scroll down to see our first blog in this series.

Resources: The following links provided many of the tips in this blog. Click to find additional helpful information.

Alzheimer’s Association brochure: Campaign for Quality Care; Dementia Care Practice for Professionals; Working in a Home Setting (available through DTN Home Care.) The Alzheimer’s Association offers quality care education programs for professionals who work in nursing homes, assisted living residences and home settings. For more information, call 1.866.727.1890 or visit www.alz.org/qualitycare.


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