With SMH Geriatrics Program Coordinator Tanya Hofmann, MSN
Patience. Understanding. Flexibility. Caring for someone who has dementia requires a lot of the caregiver.
As Alzheimer's disease or related dementia progresses, communication becomes more and more challenging. Memory loss and speech issues can lead to confusion and frustration, for both the caregiver and the person living with dementia.
It’s important to understand that a caregiver’s role is not to change or “fix” them, but to learn how to work with them — and their dementia — for the best result.
"They have a condition, a disorder," explains Sarasota Memorial Geriatrics Program Coordinator Tanya Hofmann, MSN, RN, ACNS-BC, ACM-RN. "Understanding how to work with the disease is key to caregiving."
For example, if a person with dementia insists on a certain behavior or course of action, arguing with them to change that behavior is rarely the right move. "It's best not to fight with them to get them to do what you want them to do," says Hofmann. "Instead, try to help guide them in an indirect way."
Don't talk down to someone with dementia or use a "baby voice" to speak to them. Not only is it insulting, it can make challenging communication more difficult and it's likely to damage your relationship.
“Dementia isn’t an intellectual disease,” Hofmann says, “it’s a brain function disorder.”
So, what can caregivers do to improve communication and be more understanding of the dementia experience? Hofmann offers the following guidance.
Some memory loss is normal as we age, but if memory loss is affecting your life, Sarasota Memorial’s Memory Disorder Clinic can help.
At the Memory Disorder Clinic, our team provides resources and support for people living with Alzheimer’s, dementia and other memory loss disorders, as well as their loved ones and caregivers. Connect with our team for help today: Call 941-917-7197, or click here to learn more.
Listen to Their Actions
"When someone's dementia reaches an advanced stage, you can't reason with them," says Hofmann, but that doesn't mean that their actions don't follow a sort of inner logic and have meaning. "You have to figure out what they're trying to tell you."
People act out for a reason, and it’s usually a sign that something is needed or wanted.
Do they keep getting up while you're trying to put them to bed for the night? It could be that they need the bathroom or a drink of water. Maybe they're just restless and need to walk around a little bit. Are they emptying their drawers again and again? Perhaps they're simply bored and need an activity to focus on.
Listen to what they’re saying with their actions, even if they don’t always have the words.
A person with dementia still has wants and needs all their own, and these should be respected. Sometimes, the best path forward is a compromise.
Are they insisting on sleeping on the floor, despite the problems that may bring? Perhaps putting the mattress directly on the floor is a good compromise that can satisfy both sides without leading to a harmful argument, Hofmann suggests.
Keep Calm & Try Again
If it feels like a conversation has turned into a confrontation and emotions are running high, simply stepping out of the room for a few minutes may be enough to wipe the slate clean, so you can try again. Re-enter the room with a smile on your face and restart the conversation.
Get Their Attention
The first step in having a productive conversation is simply to make sure that you have someone's attention. Watching TV while holding a conversation may be easy for someone without dementia, but such divided attention can be problematic for those living with the condition.
To establish and maintain a connection, eliminate distractions, position yourself in front of the person, and match their eye level and eye contact, says Hofmann.
Speak Clearly & Simply
When communicating with someone with dementia, speak clearly, directly and slowly. Use simple sentences, and divide complex tasks into small pieces. Keep directions simple and immediate.
For example, instead of simply telling someone with dementia to "get ready for the day," be specific and focus on one task at a time. Once a task is completed, move on to the next one.
Redirect the Conversation
If a conversation has hit a stumbling block and you sense they are becoming agitated or frustrated, try to redirect the conversation to something else, instead of forcing the conversation in a direction it does not want to go.
“You have to meet them where they are,” says Hofmann.
It can help to include some reminiscing in the conversation. People with dementia can often recall with satisfying detail events of their childhood and early lives - raising children, previous occupations, favorite travels, for example.
"Just sit down and have a conversation about those things," says Hofmann. "They might not remember what happened 45 minutes ago, but they can talk clearly about what happened 45 years ago."
Dealing with dementia can be frustrating, for the patient and the caregiver. By maintaining a positive attitude around them, you help them stay positive — and cooperative.
“If you can meet the person with a pleasant demeanor, friendly instead of coming in all full-steam ahead, that can help,” says Hofmann.
Reach Out for Help
Dementia caregiving can be very challenging. Thankfully, there are a number of programs and resources dedicated to helping people experiencing dementia and their caregivers.
SMH Memory Disorder Clinic: Partially funded by the Florida Department of Elder Affairs, Sarasota Memorial’s Memory Disorder Clinic provides assessment and evaluation by a team of neurologists, geriatricians and neuropsychologists. Clinic services include:
- Diagnostic memory evaluations
- Education and support groups
- Free memory screenings
- Dedicated monthly newsletter
- Community education
To make an appointment for a free memory screening, call 941-917-7197.
Alzheimer’s Association: Find all the information you need about Alzheimer’s and caregiving. The 24-hour helpline is staffed by social workers who are available to help: Call 1-800-272-3100 or visit alz.org.
Family Caregiver Alliance: On the Family Caregiver Alliance website, caregivers can find all sorts of necessary support and resources, can connect with other caregivers and can read about the latest research. Visit caregiver.org.
Health in Aging Foundation: Helmed by the professionals at the American Geriatrics Society, this organization is a comprehensive resource for managing the many challenges that come with aging and caregiving. Visit healthinaging.org.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. A local journalist and SMH's in-house wordsmith, Lederer earned his Master's degree in Public Administration and Political Philosophy from Morehead State University, Ky.