Alzheimer’s disease or a related illness can impair a person’s ability to understand verbal communication. Non-verbal communication—body language, tone of voice, and facial expression—takes on an increasing role, especially as the disease progresses. As a result of the inability to process verbal information, the individual with dementia might be feeling confused, anxious, irritable and depressed, and might be suffering from low self-esteem.
Discussing the Diagnosis
- Be sensitive.
- Treat the individual as an adult.
- Do not downplay the disease.
- If the person denies your explanation, accept his reaction and avoid further details at that moment.
- Consider disclosing the diagnosis in the presence of other family members, a social worker or another professional.
- Prepare simple answers to the person’s questions.
- Offer reassurance; note your desire to provide ongoing support.
- Allow the person to express his feelings.
- Encourage the individual to speak to his doctor about concerns.
Tips to Enhance Interactions
- Speak in a calm and reassuring tone.
- Talk slowly and distinctly.
- Use simple words.
- Approach the individual from the front.
- Address the person by name to get his attention.
- Maintain eye contact while speaking.
- Use positive reinforcements, such as smiles and a gentle touch.
- Allow an adequate period for a response when engaging in conversation.
- Ask only one question at a time. If the person does not seem to understand, repeat the question using the same wording. If this does not work, wait a few minutes, then rephrase it.
- Eliminate distractions, such as TV or radio.
- Avoid negative-sounding statements. Instead of “Don’t go outside,” say, “Stay inside.”
- Use humor whenever possible, though not at the individual’s expense.
- Break down tasks into one-step instructions.
- Use non-verbal gestures for cueing, such as demonstrating hand-washing rather than saying, “Please wash your hands.”
- When you need to repeat something, use exactly the same words each time. Such as, “Pick up your fork.” “Pick up your fork.”
- Be specific by limiting choices. Instead of asking, “Would you like something to drink?” ask, “Would you like milk or orange juice?”
- Label items and rooms in your home. For example, place a picture of a toilet on the bathroom door and label photographs of loved ones.
- Pay attention to cues in behavior, expressions or body language to determine what the person needs or wants.
- Evaluate your own body language to make sure you are not communicating anger or frustration. The person needs to sense the approval of his caregiver.
- Do not overcorrect the person’s word use or finish his sentences.
- Offer support and affection even when you do not understand what the person is saying.
- Check for physical situations that may make it difficult for the person to see or hear you. For example, check lighting for a glare and make sure the person is using his glasses or hearing aid.
Learning to seek and accept help is the number one job for caregivers. We can search out materials and people that can help us, and we can be enriched by friends, family and even strangers who will walk with us in this journey.
- Terri Jo Barron, Esq.
Caregiver and widow of Florida Senator Dempsey Barron