How We Communicate with a Loved One with Dementia Can Make for a Joyous Day for All!

I own a Home­Care company in in Vancouver, and most of our clients have some form of dementia. Last week, one of our clients, who I will call Mr. Jeanes, called to cancel his caregiver for the following day:


“I feel like I am doing better, Cyn, and I just want to see if I can get through tomorrow without a caregiver.”


“Sure, Mr. Jeanes,” I said, and put his caregiver on hold in case in fact she was needed.


The next day Mr. Jeanes called and wanted to know why his caregiver had not shown up. I apologized for the delay I told him that we would ensure that his caregiver was there within half an hour. Trying to explain what really happened would have been like trying to convince him that his name was not Mr. Jeanes.


Rule No. 1 of dealing with people with dementia: Never argue.


For those of us who work with people with dementia, and those people who have loved ones or friends with dementia, a few changes in the way we communicate can bring great comfort, and diffuse potentially anxious situations.


Here are some key tips that have helped me over the years:


1) Never argue. Ever. Drop your need to be right. If Dad says he wants to call Great Gramma, who died 50 years ago, just pick up the phone and dial. Be creative; leave a message on your answering machine. Trying to convince Dad that his grandmother passed away a long time ago will be confusing and distressing. In our industry, we call these little white lies “honouring their reality.” They preserve our clients’ dignity and peace of mind, two things more important than having a firm grasp on reality for many with dementia.


2) Redirect. After your little white lie, try to get Dad thinking about something else. Get Dad to tell some stories about his grandmother, and then use something in that conversation to direct the conversation elsewhere: “your grandmother used to walk every day? Did you want to take your walk now?” Talking about anything not having to do with grandmother may take Dad’s mind into a different place and he may lose the need to call his long dead relative. And if he does not forget, then just check messages to see if his grandmother has called back and repeat.


3) Be aware of your mood and your body language. People with dementia read your body language to pick up cues. If you are distressed or frustrated about anything, your mom will read that discomfort and surmise that something is wrong. She won’t know what it is and may assume that she has done something wrong. When you are calm, she will be calm. When you are anxious, she will take that on, too. Check yourself at the door as much as possible.


4) Strike the phrase “remember when” from your vocabulary. “Remember when we talked about this yesterday Mom, and you said you wanted to go to dinner?” Mom does not remember, and this question could make her confused and embarrassed.


5) Offer options and ask yes or no questions. Phrase questions simply, and ask questions that require a yes or no answer, not a narrative response. Always offer choices when possible, and present no more than two options. People with dementia are likely to pick the last choice, so craft your questions accordingly. The need to choose and feel autonomous and in control stays with us, even if our memory is fading. Offering Dad choices will give him a sense of control, a hot commodity in a dementia person’s life.


Please contact me if you have a question, or are interested in the care we provide.





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