Dementia can make it hard for people to communicate, and this can be upsetting and frustrating for them and those around them. However, there are many ways to help you support and communicate with each other. In the field of dementia care, we train staff members essential communication strategies for working with clients/residents. Family care partners can reduce negative reactions and improve quality of life by avoiding these 7 common communication gaffs.

1. "Remember when...?" 

While it can be tempting to try and jog the memory of somebody living with dementia, this kind of question is often a reminder of memories lost. This can be a frustrating or painful experience, and there’s also no evidence that training the brain in this way will help somebody hold on to memories. That’s not to say you should avoid talking about the past, but it’s better to lead the conversation and allow the person to join in. 

Try this instead: 

Instead of posing a question, try leading with ‘I remember when…’ instead. That way the person can search their memory calmly without feeling embarrassed, then join in if they like. 

2. "I've just told you that" 

Having to answer the same question several times can be frustrating, but repetition happens because the individual with dementia struggles to register new information and recall short term memories. There is little benefit to passing on your frustration to somebody with dementia, and saying ‘I’ve just told you that’ only reminds the person of their condition. 

Try this instead: 

Try to be polite and as patient as possible. It's important for somebody with dementia to feel they're being listened to and understood. Once asked (again) distract and redirect them to something they can focus on other than their question.

3. "Your brother died 10 years ago" 

It’s very common for a person living with dementia to forget about a past bereavement or ask for somebody who has passed away. Reminding them of a loved one's death can be painful, even causing them to re-live the grief they've already experienced. Care partners’ responses may vary for different circumstances, but it's always good to show sensitivity and to address the underlying emotion. A person asking for a parent (for example) may feel unsure or unsafe.

Try this instead: 

It may be better to come up with another reason for somebody's absence, while at other times a gentle reminder is appropriate. In the later stages of dementia, trying to remind them that the  person has died is unlikely to work and is best avoided. I usually turn the question around to the person asking; “I’m not sure exactly, where do you think they may be?” and then ask them for help to engage in something you’re doing to help them feel safe and needed; “Well, until they get here, why don’t we polish some silverware.”

4. "What did you do this morning?" 

Avoid asking too many open-ended questions as it could be stressful for a person with dementia and risk making them feel “crazy” or “stupid” if they can’t remember the answer. It’s better to focus on what’s happening in the present. Many of my clients say they are assessing if it’s a good day or bad day, which is fine. For general communication though, avoid these questions and give options based on their preferences.

Try this instead: 

Identify what they did and ask their opinion, such as, “I saw you reading the newspaper. I think the forecast is for rain tonight. Do you think they’re right?” You can also skip “what did you do,” and just tap into their “chit chat” skill, which remains intact until late stage. Rather than ‘what would you like to drink?’ you could ask ‘do you want tea or coffee?’ or more simply, ‘do you want a cup of tea?’

5. "Do you recognize me?" 

It can be distressing when somebody with dementia doesn’t recognize you, but remember that the feeling is mutual. Asking the person if they know who you are can make them feel guilty if they don't remember, or offended if they do. 

Try this instead: 

The way you greet somebody with dementia might change depending on the stage of their condition – judge for yourself and keep it friendly. A warm hello would suffice, or it may help to say your name and relationship, keeping it light. “Hi grandma, it’s your favorite granddaughter, Pam.”

6. "Let’s have a cup of tea now, then after that we can go for a nice walk and get lunch in that café you like in town."

Long, complex sentences can be difficult to grasp for somebody with dementia. It's difficult to process several ideas at once as cognitive abilities slow down, so it's better to give directions or instructions one step at a time. 

Try this instead: 

Use short, simple sentences as much as possible. Avoid speaking in loud environments and wait until you have the person’s full attention before you start a conversation. 

7. "Do you need some help with that, sweetie/honey/dear?" 

Words like ‘sweetie’, ‘honey’ and ‘dear’ can be patronizing for people living with dementia. This is sometimes referred to as ‘elderspeak’ and can cause older people to feel infantilized. Also, research shows that elderspeak hastens the course of dementia – it makes them worse faster.

Try this instead: 

Always remember the person behind dementia. Using their preferred name is best. This helps focus and aids concentration too.

For individualized coaching on communication techniques and avoiding behavioral triggers, please contact Atwood Dementia Group at 860.798.0369.