Theresa Kalka
Activities Director
Southern Hills Nursing & Rehab Center

Improving Interactions with Dementia Patients

Communicating with someone struggling with dementia can be quite challenging. This is not only frustrating for the visitor, caregiver, or worker, but also the dementia patient.  Dementia is not a specific disease, but a disorder that causes a loss of cognitive functions such as thinking, reasoning, and remembering due to brain failure.  As dementia progresses, the patient’s symptoms worsen over time.

dementiaThere are three different stages of dementia: mild, moderate, and severe. With mild dementia, a person can still live an independent life.  There may be minor issues such as misplacing items, and forgetting words and tasks.  This stage can last two to four years.  In this early dementia stage, please do not to assume that the patient is unable to communicate.  The communication level varies from person to person.  Including this person in conversations could greatly improve his or her quality of life.  Just remember to have patience because time will be needed for the patient to express his or her thoughts.  After time is given for an answer, be sure to engage the patient, and actively listen with your ears and eyes.  Additionally, watching the patient’s non-verbal cues and body language is advantageous because this will allow you to gain a better understanding of the patient’s emotional and physical needs.

The moderate stage of dementia can last many years.  A person is unable to be as independent due to a need for assistance with everyday tasks and the loss of effective communication skills. The environment should be void of any distractions so the patient will be able to hear and see effortlessly.  Try to avoid criticizing or correcting the patient as this will likely cause distress for the patient and could result in arguments or other agitated behaviors.  In order to improve communication, be sure to keep any questions or requests short and simple.  “Yes” or “No” questions are typically the most effective when communicating with patients, as well as step-by-step instructions to aid in their understanding of everyday tasks.  Also, at this stage, giving visual cues and written notes can only improve their understanding.

The severe stage of dementia can last many weeks or even years. The patient may not be able to communicate verbally, so it is important to utilize nonverbal communication. Full time care will need to be provided for the patient as well. Thinking outside the box is necessary as regular conversation is sometimes impossible.   While having a conversation with a nonverbal patient, keeping a relaxed, happy tone is not only important, but beneficial.  If your tone sounds harsh, that could upset a patient, who does not understand the context of what is being said. Even though the patient may be unable to communicate verbally, it is still important for him or her to know that someone cares.   The five senses: feeling, seeing, touching, hearing, and smelling are often a meaningful way to connect with patients.  A sensory blanket can be brought in to engage them, or something safe that they used in their day-to-day life such as a ball of yarn for a past knitter. Additionally, photographs (that relate to the patient) can be used for a reminiscent activity, music may allow the patient to reconnect with pleasant memories from their past, and the scent of fresh baked goods helps bring back memories of cooking experiences and family dinners. These activities as well as others have been shown to strengthen communication, and ultimately, trust between dementia patients and those who care for them.

Dementia changes a person to the point where they can no longer function as they once did.   In order to eliminate the stigma associated with dementia patients and ensure they are treated properly, it is necessary to have a full understanding of their disorder, so that you are always aware and sympathetic to their needs as they progress through each stage.  Proper communication techniques, as described above, can help each patient enjoy a better quality of life. This will not only improve the lives of dementia patients, but also the lives of those who are responsible for loving and caring for those patients.