Connecting with someone who has dementia
January 23, 2020
By Katrina Lingrell, Senior Advisor, Digital Communications, Covenant Health
This year, about 25,000 Canadians will be diagnosed with some form of dementia.
The disease, which causes cognitive decline, can affect many different facets of an individual, such as memory, thinking, comprehension, language, judgment, emotions and behaviour. And as their brain cells are affected, many people lose the ability to speak and to understand speech. This can make it challenging to maintain a relationship and communication with someone who has the disease.
“People can find it difficult and hard to connect with someone who has dementia because when the mind doesn’t send or receive messages the same way anymore, people have difficulty communicating,” says Andrea Moffitt, a social worker at Villa Caritas.
While there is no single way to address these challenges, Andrea and Dr. John McCahill, a geriatric psychiatrist at Villa Caritas, have some suggestions.
Meet the person where they’re at that day.
“Dementia is an ever-evolving disease, so sometimes you need to change your approach,” John says. “If it has to change, that’s okay.”
What makes a person with dementia happy one day may not have the same effect next time, so it’s important to be open to changing how you communicate with them. Andrea adds that it’s often best to allow the person to guide your time together.
“Just go with it,” Andrea says. “Instead of correcting them, redirect them.”
Andrea suggests starting by asking the person how they are doing that day, since their answer could tell you a lot. If they aren’t doing well, reminiscing about a positive memory or talking about something that makes them laugh could improve their mood. If they're doing well, talking with them about what makes them happy could help.
Communicating with someone who has dementia
- Never argue, instead agree
- Never say "remember", instead reminisce
- Never reason, instead divert
- Never shame, instead distract
- Never lecture, instead reassure
- Never force, instead reinforce
- Never command or demand, instead ask or model
- Never condescend, instead encourage
- Never say "you can't," instead say "do what you can"
- Never say "I told you," instead repeat/regroup
Think of items or topics that could trigger positive feelings or memories.
John and Andrea encourage family members to think of things in their loved one’s past that might trigger positive emotions and behaviours.
“We try to get a history from the family to find out who they are,” Andrea says. “These could be topics of interest, hobbies or memories.”
For example, you may want to bring photos or sentimental items to your visit or try to reminisce about a happy time in the person’s past. This can sometimes stimulate conversations or soothe a person with dementia.
If your loved one doesn’t feel like talking, try something else.
How talkative a person with dementia is can often change. This can make visiting feel awkward, and there may be other activities you can do to enjoy quality time together. You might need to get creative, or if the person is at a healthcare facility, you could ask the care team for suggestions. For example, Andrea and John say that simply sitting with the person, holding their hand or going for a walk can bring them comfort and happiness. Shifting the person’s focus to a physical object may be effective as well.
“People sometimes respond to tactile stimulation, such as a stuffed animal or a soft blanket,” John suggests. “It’s okay to go along with it and see where they are at.”
Try not to take things personally.
As dementia progresses, it can impact different areas of your loved one’s brain. This could mean they do not recognize people who were once familiar, and their behaviours may change.
“People may take this personally, but it’s the dementia affecting their behaviour and impulse control,” John says. “The person may also say or do unusual things, and family may notice marked changes in personality.”
Andrea and John suggest that while this is often very upsetting, it's important to take a step back and see these behaviours as symptoms of the disease, not a reflection of your loved one’s feelings toward you. And if the person mistakes you for someone else, it’s often better not to correct them, Andrea says.
Be kind to yourself.
Having a loved one with dementia can severely impact your physical, emotional and mental health. The Alzheimer’s Society of Canada lists depression, fatigue, declining physical health and anxiety among some of the impacts family members, especially caregivers, may face.
With this in mind, Andrea and John emphasize the importance of self-care if you have a loved one with dementia. Some people may feel obligated to visit often, at the expense of their own well-being, or may feel alone or overwhelmed by caring for the person.
“Pay close attention to your feelings,” Andrea says. “People put pressure on themselves to be there for someone, but there is no shame in needing to step away or asking for help.”