How to talk to people with dementia: 15 tips to communicate
The set 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 disorders increases with the passage of time, with more and more cases coming to consultation.
Psychologists and neuropsychologists, as well as any other type of professional within the field of health or even social care, must be properly prepared to deal with this type of patient, taking into account the possible difficulties that may arise. .
Among them we can find a basic aspect that can make interaction very difficult, both to assess their abilities and to perform different therapies that help maintain and maximize their abilities: 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 .
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Briefly recalling the concept of dementia
We understand dementia before a type of disorder characterized by the presence of the 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 (provoking a previously non-existent limitation). It is usually about a deterioration that progresses progressively and irreversibly , although there are some that are treatable or in some cases even have a full recovery (such as those generated by infections).
This deterioration is usually due to organic causes, although in some cases the exact reason for its occurrence is unknown (although there are known neurochemical and structural alterations that generate or participate in the symptomatology, not because these occur). The evolution can be very variable in each case, although the trend is towards a progressive deterioration or in most cases staggered.
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How to talk to a person with dementia
There are a lot of different dementias, which can affect different abilities. In many cases it ends up presenting a deterioration in the ability to attend, remember, retain or even understand and processing what they are told can make it complex to treat and even evaluate them. That is why below we offer a series of indications that may be useful when treating a patient of these characteristics.
1. Speak clearly and vocalizing
A key aspect when communicating with a patient with dementia is the fact that be willing to adjust to the needs of the person . Our tone should adjust to what the person needs and should be able to understand what we are expressing. Vocalize is fundamental.
2. Short sentences, slow pace
Employing excessively complex structures will hinder the understanding of the patient. It is necessary to use a vocabulary adjusted to the patient's capacity (and to their knowledge and level of studies) and phrases the shorter and clearer the better. Avoid ambiguities, and use a slower pace .
3. Repeat things
Whether there are problems coding new information, retaining it or simply paying attention, it can be difficult for a person with a more or less advanced dementia to capture what is requested from the first moment. Repeating the instructions can be more than necessary depending on the case.
4. Make sure you have understood what you say
Linked to the above, it is essential to ensure that the patient has understood what is requested. This must be done in such a way that the patient does not feel ridiculed or bad for requiring new explanations .
And it is necessary to bear in mind that many people, even if they maintain sufficient capacities, pretend to have understood what they are told by shame or by social desirability, and this is something that is actually hindering efficient communication.
5. Tolerate frustration and do not get angry
The fact that a person does not understand what we want to say, does not achieve an improvement or that there is no efficient communication between patient and therapist can be frustrating. The treatment with this type of patients may require a certain amount of patience, in addition to taking into account that the patient is not doing it on purpose.
6. No reproach
It may seem obvious, but often the environment or even some professionals (especially those not specialized in this sector) tends to reproach one way or another for forgetting or losing faculties. The person does not forget things because they do or because they do not value what they are told: they are being affected by a disorder that you can not control and that causes you not to be able to store the information .
Also, especially in the initial periods of dementia, patients are usually aware of the presence of deficits. To reproach them will only increase their discomfort and anguish in the face of the deterioration they have already perceived.
7. Avoid distractors
It can be difficult for a person with dementia to maintain concentration. That is why it is advisable that communication attempts are carried out in a context where there are as few distractions as possible. A crowded office or a radio on for example they can make the thread lose easily .
8. Find ways to communicate
It is not uncommon for serious problems to appear orally. Also, in advanced stages, people with dementia can go to silence, not being able to follow a conversation to lose concentration or even to remain in a state of absence. It is important to try to find a way to communicate, because socialization is important and can be reassuring.
If the oral language does not work, perhaps gestures and mimicry, or pictures or drawings representing different concepts may be used . They can also serve songs that are relevant to them. If you lose concentration, a caress or give them a little squeeze in the hand can help them to follow a little more the thread of the situation.
9. Start the interaction
While it may be interesting to let the patient who is the first step to communicate, the truth is that it can be complicated. Many dementias end up affecting the ability to motivate action and interaction, which will generally be more efficient let the professional try to establish the interaction and direct it .
10. Better indications or concrete 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 asked or the question asked. Making general proposals in the first place you have to imagine and generate responses, as well as having to process the idea of whether or not to do so. This implies a much greater effort, as well as greater likelihood 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. It is not the same to say to someone to raise a hand to ask if they could lift it. It is the first case you can do it, while in the second it can be interpreted as a mere question to answer. Also, perhaps the decision making is one of the damaged skills. It may be useful to value it, but you have to keep in mind what you are seeing at each moment. One hand. The capabilities 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 in positive, avoiding the use of negations that are more complex to understand.
12. Give it time
Sometimes, something that is interpreted as lack of memory or reasoning capacity can actually be a problem of processing speed. By this we mean that we do not have to hurry and jump from one thing to another, but we have to give the patient a prudential time in order to process the information and / or express itself .
13. The position, important element
Another aspect to take into account when talking with a patient with dementia is the place or space that we occupy. We must place ourselves in front of the person, facing it and relatively close , in such a way that our person captures their attention and has greater facility to observe our gestural language and to listen to our voice.
14. Do not run 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 to have hearing problems, something that in turn must be assessed when exploring a patient in order not to confuse a sensory problem with symptoms of dementia . Likewise, it is necessary to assess previously whether or not it has been schooled, being this also something relevant in terms of adjusting the tests and treatments to their needs.
15. Always keep in mind and treat him as an adult and worthy person
A person with dementia is still an adult person. The treatment towards her must always respect their dignity and should be treated with respect .
Even if the person is not aware of where they are or with whom, they should be treated as adults and not infantilized. Likewise, they should not be spoken of as if they were not present, no matter how much they do not show any reaction to stimulation or language.