Module Five

Communicating with an older adult who has dementia can be challenging. They might struggle to find the right words, understand what’s being said, or express their thoughts. Despite these challenges, their need to communicate and connect remains as strong as ever.

Here’s how we can make those conversations more meaningful:

Be patient. Give them the time they need to speak without jumping in to finish their sentences or correct them. This respect can ease their frustration.

Listen actively. Focus on their words, and also pay attention to non-verbal cues. Sometimes, what they’re trying to say goes beyond words.

Encourage conversation. Even simple exchanges can provide comfort and a sense of normalcy.

Use clear, simple language. Speak in short, direct sentences to make it easier for them to follow.

Reassure them. If they’re struggling or become upset, a calm and reassuring voice can make all the difference.

Your patience and understanding are key. They can turn a potentially frustrating conversation into an opportunity for connection and expression.

Effective communication with people who have dementia is essential. Here are some key points to remember:

Use a normal, calm tone of voice to show warmth, understanding, and respect. Avoid any kind of condescending baby talk, like using the term “dearie.”

Simple yes or no questions can make it easier for them to respond—complex questions can be too much. If you need more detail, ask a family member instead of the person with dementia.

Give them plenty of time to answer. Rushing can increase their stress.

Highlight their strengths and what they can do. Positive reinforcement, like praising them for getting exercise, can boost their mood.

Always let them know what you’re going to do before you do it. This helps maintain their dignity and understanding of the situation.

Assist with orientation by gently reminding them of the day and time. Avoid asking them to provide this information themselves, as it could lead to feelings of failure.

Encourage them to share memories and stories. Looking at photo albums or talking about the past can be enjoyable for them and helps build your relationship.

If they say something untrue, don’t correct them; instead, engage them in conversation about the topic, like asking them to tell you about a family member.

Redirect the conversation if they become fixated on something they can’t have. Use what you know about them to switch to a topic that might interest them.

Remember, if you talk about the person with dementia while they’re present, assume they can hear and understand you. Always speak in a way that preserves their dignity.

Communicating with kindness and respect is key to supporting people with dementia, and helping them feel valued and understood.

As we navigate the progression of dementia, communication can become a challenge. It’s our job to recognize these changes and support our clients in sharing their thoughts and needs.

In the early stages of dementia, individuals often know that they’re struggling to find the right words. Imagine knowing what you want to say but the words just won’t come. It’s frustrating. Here’s how we can help:

When they’re searching for a word, offer suggestions gently without overwhelming them. It’s like giving them the missing piece of a puzzle.

Use prompts or cues related to the topic they’re trying to discuss. These hints can jog their memory and ease the flow of conversation.

Be patient and give them the time they need. Rushing can add to their frustration.

By assisting with patience and understanding, we help maintain their confidence in communication, which is crucial for their well-being and sense of self.

As dementia progresses into the later stages, individuals might not be as aware of their communication struggles, but they may still feel the frustration and agitation that comes with trying to express themselves.

Here’s how we can best support them:

Offer assistance with finding words, but only when it’s really needed. If they’re just a little stuck, give them space to find their way.

Resist the urge to correct them or insist on a point. Our goal is to reduce stress, not increase it.

Visual aids can be very helpful. Use pictures or objects to spark recognition and memory. For instance, showing a picture of a mealtime can be a gentle way to indicate that it’s time to eat.

Our approach is to be as understanding and supportive as possible, providing help without taking over the conversation.

Repetitive behaviors are common in dementia, such as asking the same questions or repeated hand-rubbing. These actions may seem small, but they can be tiring for caregivers.

Here’s how we can manage these behaviors:

Distraction can be an effective tool. Gently engaging the person in a different activity can break the cycle of repetition.

Respond to their questions with calmness each time they ask. It’s important for them to feel heard and answered.

Use visual aids to help with memory. Calendars, notes, and pictures can serve as reminders and reduce the need for repeated questions.

If they repeatedly rub their hands, offering them a tactile object might be comforting and can occupy their hands.

Where possible, incorporate repetitive actions into everyday tasks. For example, if they like folding things, give them towels to fold during laundry time.

Also, keep an eye out for what triggers these behaviors. Understanding what sets off the repetition can help in preventing it.

Our approach is to be patient and resourceful, finding ways to reduce stress for both the person with dementia and the caregiver.

Wandering is a behavior that can cause real worry for caregivers. It can happen for many reasons, like boredom or the person with dementia looking for something familiar.

To help prevent wandering and keep the individual safe, consider these steps:

Make sure gates and doors are secure to prevent the person from leaving unnoticed.

Use ID tools like a shoe tag or bracelet that includes their name, your phone number, and address. This can be crucial if they do wander off.

Carry pocket cards that offer instructions on what to do if they become lost. If you’re with someone who begins to wander, stay calm and don’t leave their side.

Stick to regular daily routines which can be comforting and reduce confusion.

Encourage physical activities. It’s a positive way to channel their energy and may lessen the urge to wander.

Engage them in mentally stimulating activities to keep their minds occupied.

Offer regular reassurance about their location, helping to orient them to their surroundings.

If wandering is a regular issue, there’s also the Alzheimer Wandering Registry to consider:

Registering the person with dementia means they’ll have a medic alert bracelet or ID tag, making it easier for others to help if they get lost.

Their details are shared with local law enforcement, like the police department or RCMP, increasing the chances that they’ll be returned home safely and quickly.

Remember, our goal is to create a secure environment that still respects the dignity and independence of the person with dementia.

It’s not uncommon for people with dementia to experience anger, often due to the brain changes caused by the illness. They might react strongly or suddenly, and it’s important to remember that this is a symptom of dementia, not a personal attack.

Here’s how we can help manage these situations:

Be observant for any signs of growing anxiety, like restlessness, as it can be a precursor to anger or aggression.

Try to identify what might be triggering the anger. Is there an immediate cause, like a loud noise or a disrupted routine? Are they afraid or in need of comfort? Could they be overwhelmed?

Approach them with support and reassurance, using a calm and gentle tone. Your aim is to understand their needs and address them.

Minimize noise and commotion around them. Keep daily activities consistent and routines predictable to provide a sense of security.

When you’re communicating, avoid confrontation. Stay calm and patient, even if you’re feeling frustrated.

Break activities into simple steps and give clear, concise instructions. If they become upset, help shift their attention to something else—they may forget what was making them angry.

Approach them in a non-threatening way: from the front, at eye level, and move slowly to avoid startling them.

Be cautious with physical contact. While sometimes a gentle touch can be soothing, it can also escalate agitation if not welcomed.

Distraction can be a powerful tool. Change the environment or the subject to defuse tension. And remember, safety is paramount. If you feel at risk, it’s okay to step away and seek assistance.

Dealing with anger in dementia is challenging, but with these strategies, we can often prevent or de-escalate tense situations, ensuring safety and dignity for all involved.

Dealing with socially inappropriate behavior is a common challenge in dementia care. As the disease progresses, individuals may gradually forget or disregard the social rules we all follow, often without even realizing it.

Here’s how to handle these situations professionally and compassionately:

Remain calm at all times. Reacting strongly can worsen the situation. Instead, your composure can help keep the person with dementia at ease.

Focus on being positive and reassuring. Don’t highlight the mistake they’ve made, as it could embarrass or confuse them.

Distraction is a useful technique. Engage them in a conversation and guide them discreetly to a more private area where they can correct their behavior without feeling exposed or shamed. For instance, if they forget to put on a piece of clothing, calmly walk with them to where they can get dressed.

Never scold or reprimand. Remember, they’re not intentionally breaking social norms. Criticism is likely to upset them and may not be understood.

By managing these moments with tact and empathy, we can help maintain the dignity and comfort of those in our care, even when they’re unaware of social missteps.

When caring for individuals with dementia, we may encounter expressions of sexual desire, which can manifest in various behaviors. Understanding and managing these behaviors is a sensitive aspect of care.

Here’s how to handle such situations:

Look for underlying needs. Sometimes actions like undressing might signal a basic requirement, such as needing to use the restroom, or could indicate loneliness or a need for attention. Misinterpretation of a caregiver’s actions could also be a factor.

Provide privacy when it’s clear that the person is expressing sexual desire. It’s important to handle this with respect and without judgment.

If sexual behavior is inappropriate or cannot be privately managed, gently redirect the individual to another engaging activity that they find pleasurable.

Maintain a professional demeanor if you become the focus of sexual attention. Stay calm and redirect the person to a different, non-sexual activity.

In cases where a person makes advances towards visitors, tactfully steer them away from the situation. If needed, explain the behavior to the visitor with sensitivity to preserve the dignity of the person with dementia.

Be mindful of your own actions and avoid physical contact that could be misinterpreted, like sitting too close or touching in a way that could be construed as intimate.

It’s essential to navigate these scenarios with dignity, maintaining a balance between addressing the person’s needs and ensuring that all interactions are appropriate and respectful.

In dementia care, we may encounter aggressive verbal behaviors. It’s key to handle these moments with professionalism and empathy.

Here’s a look at these behaviors and how to respond:

Behaviors to Look Out For:

Cursing or verbal outbursts.

Unusual noises or screaming.

Verbally inappropriate sexual comments.

Possible Triggers:

Tensions with others or the environment.

Physical discomfort or needing help with a task.

Social interactions that may cause confusion or frustration.

Unfulfilled needs, whether emotional or physical.

Overwhelming environmental stimuli, like loud noises.

Effective Interventions:

Spend quality time with the client. Your presence can be reassuring and can help de-escalate tensions.

Engage them in conversation. A gentle chat about a favorite topic can redirect their focus.

If needed, consult with a team member. Fresh perspectives can offer new solutions.

Recall what has been effective before. Past strategies can sometimes be the key to soothing current upsets.

Minimize excess noise and bustle. A calmer environment can help to reduce agitation.

By understanding and addressing the triggers of aggressive verbal behaviors, we can better support our clients, ensuring their dignity and well-being remain at the forefront of our care.