Stage-dependent Goals Caregivers need to communicate differently with those with dementia at different stages of the disease. As the disease progresses, more skill is required to convey messages and establish mutual understanding. It is important to remain flexible and aware of how effective different techniques are in different situations. As dementia progresses from early to late stages, communication strategies, goals, and expectations need to change. In the early stages, the goals of communication are to:
In some ways, these are relatively easy goals to achieve, because the main communication problem involves word finding.
In the middle stages, the goals of communication are to:
In the late stages, the goal of communication is to maintain communication by emphasizing non-verbal techniques.
Communication Strategies Research on the best ways to communicate with care recipients who have dementia have identified four strategies that are effective:
These four strategies build on each other and are best used in combination. Show respect The first way to show respect is to address the care recipient by her/his preferred name. The second way of showing respect is to use good manners such as saying “please” and “thank you.” The third way of showing respect is to invite the care recipient to participate in something rather than telling or demanding them to do it. The fourth way of showing respect is to give priority to the care recipient’s agenda over yours. Attend first to what the care recipient wants or needs before you attend to what you want. Decrease environmental stress Those with dementia can react very negatively to stress. For a person with dementia, even a small amount of stress can produce what is known of as a catastrophic reaction (serious emotional reactions characterized by emotional outbursts, agitation, and sometimes physical aggression). The best strategies for decreasing environmental stress include:
Empathy and validation The goal of this strategy is to affirm the feelings behind the message that the person with dementia is sending rather than focusing on the content of the message. The task for the caregiver is to carefully observe the emotions, behaviors, and environment of the care recipient, and then reflect back what the caregiver believes is going on. Strategies for showing empathy and validation include:
Communication Don’ts
Communication Do’s
Last modified 07/16/2009