The Importance of Person-First Language
When discussing a person with dementia, the language we use holds immense power. It can either affirm their identity and value or reduce them to their diagnosis. Person-first language is a communication practice that emphasizes the individual before their condition. For example, instead of saying “a demented patient,” the preferred and more respectful term is “a person with dementia” or “a person living with dementia.” This small but significant shift acknowledges that dementia is just one aspect of who they are, not their defining characteristic.
Using respectful terminology helps combat the stigma and stereotypes often associated with cognitive decline. It promotes a more positive care environment and encourages others to see the person beyond the illness. For families and caregivers, adopting this language can strengthen their relationship with their loved one and validate their continued worth as a human being.
Moving Beyond Stigmatizing Labels
Outdated and dehumanizing terms like “senile,” “demented,” or “empty shell” should be avoided completely. These words are not only inaccurate but also incredibly damaging. They suggest that the individual has lost their mind or identity, which is a harmful misconception. The person-first approach reminds everyone that the individual's history, memories, and personality still exist, even if they are more difficult to access or express.
Describing Specific Symptoms and Behaviors
Rather than labeling a person with dementia with broad, stigmatizing terms, effective communication relies on describing specific, observable symptoms and behaviors. This not only provides a more accurate picture but also helps in developing tailored care strategies. Describing what you see and hear is more helpful than making generalizations about their personality.
Cognitive Changes
- Memory Loss: Not all memory loss is the same. Instead of saying “they have no memory,” you can describe the specific type of memory loss. For instance, “She has trouble remembering recent conversations but can vividly recall her childhood” or “He often forgets where he placed his keys but remembers his wife’s birthday.”
- Language Difficulties: A person may struggle with finding the right word, lose their train of thought, or have trouble following a conversation. You can say, “They have difficulty finding words and sometimes repeat themselves” or “I’ve noticed they can’t follow multi-step instructions anymore.”
- Reasoning and Problem-Solving: Describe a specific instance of difficulty with complex tasks. “He is struggling to pay bills and manage his finances independently” is more accurate than “He is confused all the time.”
Psychological and Behavioral Changes
- Agitation and Anxiety: These can manifest as restlessness, pacing, or excessive worry. Instead of labeling the person as “difficult,” describe the behavior and potential triggers. “He becomes agitated when his routine is disrupted” or “She seems anxious in large crowds.”
- Repetition: Repeating questions or stories is a common symptom. You can describe this simply: “He asks what time lunch is every few minutes.” Redirecting and answering patiently is key.
- Suspiciousness or Paranoia: If the person believes items are being stolen or people are conspiring against them, describe the delusion without validating it. “She becomes suspicious that someone is stealing her belongings.”
Understanding the Different Types of Dementia
Describing symptoms can also be more precise by referencing the specific type of dementia, as symptoms can differ. It is important to remember that many people, especially those aged 80 and over, have a mix of dementia types.
| Type of Dementia | Key Symptoms for Description |
|---|---|
| Alzheimer's Disease | Progressive short-term memory loss, difficulty planning, changes in mood and behavior. Later stages involve more significant cognitive decline and impaired motor skills. |
| Vascular Dementia | Primarily impacts thinking speed, attention, and executive functions. Memory loss may be less prominent in early stages. Can have a stepwise progression. |
| Lewy Body Dementia | Fluctuating cognition and alertness, visual hallucinations, and motor symptoms similar to Parkinson's disease (e.g., tremors, stiffness). |
| Frontotemporal Dementia | Significant changes in personality, behavior, and language skills. Often occurs at a younger age. Can lead to a lack of social awareness or apathy. |
Compassionate Communication Techniques
Communicating with a person living with dementia requires patience, empathy, and specific techniques to manage challenges and reduce frustration.
- Use Simple, Clear Sentences: Avoid complex language, jargon, or multi-step questions. Speak clearly and at a moderate pace.
- Maintain Eye Contact and Calm Body Language: A calm demeanor helps create a sense of safety and security. Approach from the front to avoid startling the person.
- Offer Choices: Give limited choices to empower the person. Instead of “What do you want to wear?” ask, “Would you like to wear the blue shirt or the green one?”
- Validate Feelings, Don't Correct Facts: If they are reminiscing about a past event as if it were present, validate the feeling behind the memory rather than correcting the timeline. For example, “That sounds like a beautiful memory.”
- Use Redirection: When faced with repetitive questions or agitation, gently redirect the conversation or activity. Engage them in a simple task or change the subject to something soothing.
Preserving Identity and Dignity
The most profound way to describe a patient with dementia is to remember that they are, first and foremost, a person with a history, feelings, and individuality. Their diagnosis does not erase who they were. Sharing stories about their life, looking at old photos, and engaging in familiar hobbies can help reinforce their identity and sense of self. Caregivers can assist with this by using life story booklets or by keeping a list of their loved one's preferences and important life events.
For more guidance on communicating effectively and compassionately, the Alzheimer's Society offers excellent resources on language use.
Conclusion
Understanding how to describe a patient with dementia involves moving from broad, outdated labels to person-first language and specific, observable descriptions. This shift is not just about political correctness; it’s about providing care that respects the individual's dignity, preserves their identity, and fosters better communication. By focusing on the person, not the diagnosis, we can create a more compassionate and supportive environment for those living with dementia and their loved ones.
