Communication with dementia patients

Dementia is an insidious disease: Mental abilities deteriorate, often affecting short-term memory first. As the disease progresses, long-term memory is also affected. As the disease progresses, communication with dementia patients becomes increasingly difficult – a challenge for relatives. As dementia progresses, the brain changes and so does the way in which dementia sufferers perceive their surroundings and how they communicate. When communicating with dementia patients, carers should have two things in particular: Patience and affection.

Stage-appropriate communication: mild, moderate, severe dementia

Dementia progresses in stages. Communication with those affected should always be adapted to the current possibilities and conditions. Communication with people suffering from mild dementia is therefore very different from communication with people suffering from severe dementia:

In mild dementia, the disease manifests itself in forgetful moments, forgetting names and initial difficulties with complex tasks. Those affected sometimes seem distracted and need more time to respond. It is important to be patient and give those affected time to respond. Communicate in simple, short sentences, speak slowly and support your words with gestures to make communication easier.

In the moderate stage of dementia, there are clear gaps in thinking and memory and those affected need more help with everyday activities. They notice the decline in their abilities and often display “façade behaviour” by denying mistakes or making accusations. It is crucial to react sensitively to their emotional state and show appreciation. Biography work, such as looking at photos from different stages of life, can create positive moments. Remember that body language is contagious, and try to relax and cheer your loved one up with positive signals.

In the advanced stages of dementia, those affected often lose their ability to communicate verbally. Non-verbal and emotional communication becomes crucial. The basal stimulation method, which stimulates the senses, is helpful. In this phase, “less is more” is advisable, whereby being together in silence and touching are important. A brief shared experience of “I am not alone” for a few minutes can be meaningful. Give your loved one affection and appreciation by hugging or holding hands.

Verbal and non-verbal communication in dementia:

In the early stages, it is often still possible to communicate verbally, i.e. to express oneself verbally or linguistically. In later stages, non-verbal communication plays an increasingly important role. Information, feelings or messages are conveyed without the use of words or spoken language. This happens through body language, gestures, facial expressions, eye contact, tone of voice, touch and other non-verbal signals.

In the early stages of dementia, verbal communication is still effective. It is helpful to speak slowly and clearly, ask yes-no questions, allow sufficient time for answers and support words with gestures. Rhythmic speech, rhymes and music can awaken memories and serve as a memory aid, for example by singing together or reciting familiar poems.
In the later stages, when verbal communication becomes challenging, non-verbal communication is crucial. Despite the lack of words, a connection can be established through body language and non-verbal signals. The concept of basal stimulation emphasises the stimulation of the senses in order to build a trusting relationship.

What do people with dementia need to be able to communicate?

Person-centred care according to Tom Kitwood emphasises the needs and personhood of the person with dementia. It places the person at the centre and not the illness. According to Tom Kitwood, the needs of people, especially those with dementia, can be represented in the shape of a flower. Love forms the core of this flower, around which the “petals” of comfort, attachment, inclusion, occupation and identity are grouped.

 

It focuses on love, closeness, security, comfort, social connection and identity. In home care, it is important to involve the relative in everyday activities and to promote their identity through memory care. Love and compassion, expressed both verbally and non-verbally, are crucial to maintaining bonds and giving the sufferer a sense of security.

Note: You can find more tips for relatives of people with dementia here.