This article contains informative tips to make communication easier for you and your older relative living with dementia; giving you practical information on how to deal with the challenging behaviour you may be presented with, especially if you’re their primary carer.
Dementia is an umbrella term to describe various diseases which cause a decline in mental ability. It damages different parts of the brain which leads to memory loss, trouble communicating effectively, disruptions in decision making and confusion. For more detailed information on the different forms and symptoms of dementia, have a look at our article What is Dementia?
What is Dementia?
As a direct result of this damage, your loved one's personality will change somewhat, with mood swings, agitation and irritability a prominent feature. For this reason, it’s essential that you know how to handle episodes of increased irritability so you can improve the quality of your relationship.
As a caregiver, you should know that how you behave around your loved one can have a direct impact on their mood. Dementia should be seen as a disability, for which you can make compensations to help alleviate symptoms. They are still emotionally aware and if you’re stressed or irritated, they pick up on this. Tone of voice, facial expressions and body language are all key factors in projecting how you’re feeling. Try to remain as calm as possible around your loved one and avoid adding further stress to the situation.
One mistake many people often make is talking to their older relative like a child. Try your utmost to avoid negative language and limit your usage of words such as don’t, can’t, mustn’t and no. If you talk in this way, it will make them feel as though they’re being told what to do and it may cause increased irritability. Using positive language will encourage your loved one instead of making them feel inferior, or that they’ve lost part of their autonomy.
Also, as they progress through the stages of dementia they’re comprehension becomes diminished. For this reason, you should try to use simple words and short phrases so as to not cause them further confusion or stress. Asking simple and direct questions, with yes/ no answers is best as it limits the choices for an answer, which in turn helps them to make the decisions and to feel more secure in themselves and their decision making abilities.
If you’re asking them something and they don’t understand you, avoid repeating what you’ve just said. People are often tempted to say the same thing over and over, but slower and louder. This can be patronising and make your loved one feel paranoid. Instead, rephrase what you’ve said. This will distract them from the fact they’ve misunderstood you and refocus their attention on a seemingly new question.
Also, if you’re talking about something particular avoid the use of pronouns; he, she, it etc. Name the person or place directly to avoid confusion at all costs.
Respect their personal boundaries and talk to them at a distance that’s comfortable for them. Always try to be at their level when you’re talking to them, especially if they’re sitting down. Talking down to them can be very intimidating and make them feel insecure. If they allow you, hold or pat their hand to give them more reassurance and that you’re there to support them.
A common feature of the disease is the repetition of phrases, or constantly asking you the same questions. This can become very tiresome for the caregiver and really start to grate on you, but the main thing to remember is that symptoms like these are often triggered by anxiety, fear, boredom or even their environment. If they do begin to repeat what they’ve said a number of times, don’t draw attention to it. This can make them feel even more anxious or like they’re a burden on you. Instead, distract them with a different topic or an activity to keep their mind focused on something different.
You should also give them time to respond to what you’ve said. Let them take their time to answer you, as they may feel pressure to answer as fast as possible causing them distress. Try your best not to cut over them while they’re still processing what you’ve said. Dementia affects the way they understand and retain new information, so give them the space they need to comprehend what’s going on before barging in with a new topic or task.
When your older loved one is talking to you, make sure you give them your full attention. Stop what you’re doing and show them you’re paying attention to them. Use eye contact, facial expressions and head movements to convey you’re following what they’re saying. They may have lost the ability to convey complete ideas, but avoid cutting over them or trying to finish their sentences for them. Instead, wait until they’ve finished talking and relay back to them the idea you feel they wanted to express to make sure that’s what they want.
Also, pay attention to their facial expressions and body language. When it comes to dementia, you have to learn to listen in alternative ways. Don’t only focus on what they’re saying verbally, but try to keep an eye out for what they may be trying to tell you through gestures too.
If you have a long list of things you want to get done in the day, break it down into smaller tasks. Simple things like writing down what’s to be achieved in that particular day e.g. get dressed, take medication, have breakfast; alongside clear times for everything can be a great source of comfort for your loved one. They may have days where they’re feeling extremely insecure in themselves and don’t know what’s going on. Having a clear list of what they need to do when they need to do it, and being able to cross tasks off, can provide them with a sense of achievement.
This one may seem pretty obvious, but more often than not we find ourselves getting caught up in a discussion and quickly enough it turns into a full-blown argument. Remember that dementia is a disease which affects the brain and your older relative will inevitably become more agitated and at times aggressive with you and those around them. Try your very best to separate the person from the disease and if you do find yourself in the middle of a heated discussion for whatever reason, tell them they’re right and you’re wrong and simply walk away. It’s much easier for you to remove yourself from the situation. Your loved one’s brain won’t tell them they’re wrong and they can no longer rationalise the way they used to. Always be the bigger person and know that by letting them take the blame isn’t going to make anyone feel better and it will only escalate the issue.
When you want to discuss something with your older parent, the best way to hold their attention is by removing possible distractions. As they progress through the stages of dementia, their ability to focus and concentrate becomes increasingly difficult. Don’t be surprised if they wander off or drift into another topic of conversation if you don’t first make efforts to put yourself in the focus of their attention. Turn off the TV and the radio, close the door and create a quiet, calm atmosphere where the focus is on you. Make direct eye contact, clearly state who you are and your relation to them and give them a clear idea of what you want to talk about.
As you care for your loved one, it can be all too easy to neglect yourself. You have to nurture yourself so you can give the best you can to help someone else. Ensure you’re getting enough sleep and eating well. If you’re tired and feeling rundown, it will only make you more irritable and less able to care for your older parent on a physical and emotional level.
Remember to look for support, and never feel like you’re alone on this challenging journey. If you’re feeling stressed and overwhelmed, contact your local health provider. They can seek assistance for you in the form of Home Support Services or respite care in a nursing home, all to ease the burden on you and give you a bit of a break too.
For more information on what support services are available, check out our article Care Support available to your loved one as they age.
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