Communication Adjustments for Dementia: Preserving Dignity

When a loved one is diagnosed with dementia, the term hits hard, and there’s a feeling of not knowing how to move forward. At least, that’s the way I felt when both of my grandparents were diagnosed with two different forms of dementia on the same day. Initially, I thought all hope of communication with them was lost forever.

What caregivers and other family members need to know is this: while it is true that the various dementia types ultimately do affect the core mental functions—including their language skills—these changes don’t occur all at once. In fact, the progression of dementia is relatively slow—so slow, in fact, that it can take quite a while before family members or friends actually begin to notice anything is wrong at all.

If, however, the condition has been underway for some time, the need for care may present itself very suddenly—again, this was my personal experience. Because I became a caregiver literally overnight, I automatically assumed that all communication was compromised. Talk about a steep learning curve!

One of the first things I had to learn was that arguing with my grandparents never went anywhere good. When Grandma would say something unusual, my first response was to correct her. She’d react with hostility, telling me that I was wrong! Well, in the early days this led me to think I needed to press my point even harder. Yeah, that was an epic fail.

Eventually I learned how important it was for me to make every effort to protect their dignity; dementia notwithstanding, they were still my grandparents who deserved my respect. And over time, I learned to make small changes in my verbiage—small changes for me, but what a huge difference it made for my grandparents!

• I learned to avoid saying, “Do you remember…?”
  • Instead, I found I could tell them what I remembered; this set them free from feeling bad for not remembering something.

• I learned not to give a series of instructions like, “Get your coat, let’s get in the car and go to the grocery.” It was too much for them to process all at once.
  • Instead, I would break the list down into three separate instructions, giving each one at a time.

• As their dementia became more advanced, I learned not to “hit” them with information that was emotionally charged.
  • When they would ask about a loved one who had already passed away, I learned to reassure them that the person was doing fine. This “therapeutic lying” kept them from feeling a grief that they wouldn’t even remember a few minutes later—which, ironically, would start the whole cycle over again.

Learning to communicate with a dementia patient is a challenging endeavor, but it’s worth the effort. It will always be changing, sometimes only slightly, sometimes in fairly large leaps, but nothing beats the smile you see when you’ve made that communication connection.