Understanding the challenge of explaining dementia
Explaining a complex medical condition like dementia to someone with impaired cognitive function is not a straightforward task. It can provoke anxiety, confusion, and distress, especially for individuals who lack the capacity to process and retain new information. Their perception of reality is different, so a factual explanation may be entirely irrelevant or even harmful. The goal is not to deliver a medical diagnosis but to manage the current situation with empathy and reduce fear and frustration.
Prioritizing emotional safety over factual truth
The conventional approach to communication, which prioritizes accuracy, often backfires in cases of advanced dementia. It can feel like a constant, stressful test for the person with dementia, highlighting their memory gaps and causing them to feel insecure or embarrassed. Instead, consider shifting your focus from correcting their misperceptions to validating their feelings. If they believe they are waiting for their parents, acknowledging their feeling of expectation ("You're feeling a bit antsy today, aren't you?") can be more helpful than stating their parents are no longer living.
Assessing the stage of dementia
The best way to communicate depends heavily on the stage of dementia. In the early stages, an individual might still have the capacity to understand their diagnosis, even if they sometimes forget. A conversation about a "brain change" or "memory issues" might be possible. As the disease progresses, these conversations become less and less productive. Therefore, ongoing assessment of their cognitive state is crucial to adapt your approach appropriately. Some days might be clearer than others, so flexibility is key.
Techniques for compassionate communication
The 'Therapeutic Fibbing' and redirection
Therapeutic fibbing is a communication strategy where you avoid confronting an individual with a distressing truth by using a gentle, supportive untruth. For example, if your loved one insists on going home to a house they no longer own, saying, "We can't go right now, the car is in the shop," is kinder than saying, "We sold that house 10 years ago." This technique reduces agitation and preserves their peace of mind. Redirecting their attention to a pleasant activity or memory can also shift their focus from a frustrating thought.
Keep conversations simple and direct
When discussing topics related to their memory or condition, use simple, easy-to-understand language. Avoid medical jargon like "cognitive impairment" or "neurodegeneration." Instead, use phrases like "Sometimes your memory isn't as good as it used to be" or "We all have our off days with remembering things." Frame the discussion in a way that is not blaming or negative. Use sentences that focus on the present moment, such as, "Let's look at these old photos together," instead of trying to fill in forgotten details.
The power of non-verbal cues
Your tone of voice, body language, and facial expressions are powerful communication tools. People with dementia often retain their ability to read emotional cues long after verbal communication skills decline. A calm, warm, and patient demeanor can be incredibly reassuring, even if the words are not fully understood. Holding a hand, offering a gentle hug, or just sitting quietly together can convey more comfort and understanding than any explanation.
Creating a supportive environment
Use memory aids and routines
To reduce frustration related to memory loss, establish simple, consistent routines and use visual aids. This can include a whiteboard with the day's schedule, labeled drawers, or a calendar with upcoming events. These tools provide a sense of stability and reduce the need for difficult explanations about forgotten plans or locations. Consistency is a powerful ally in managing daily life with dementia.
The 'Do's and Don'ts' of explaining dementia
Here's a comparison to guide your communication approach:
| Do | Don't |
|---|---|
| Validate feelings: Acknowledge their emotions first. | Correct factual errors: Avoid pointing out their mistakes. |
| Speak gently: Use a calm, reassuring tone. | Argue or debate: Challenging their reality causes distress. |
| Simplify explanations: Use short, clear sentences. | Use medical jargon: Confusing terms increase anxiety. |
| Redirect attention: Shift focus to a pleasant topic. | Drill them with questions: Testing their memory is hurtful. |
| Use non-verbal comfort: Offer touch and a warm smile. | Show frustration: Your negative emotions will be perceived. |
Conclusion: Adapting to their reality
Ultimately, learning how to explain dementia to someone with dementia is less about giving a perfect explanation and more about adapting to their changing reality with love and compassion. It’s a journey of continuous adaptation, where the most important message you can convey is that they are safe, loved, and valued, no matter what their memory recalls. Focus on building moments of joy and connection in the present, as those are the moments that will continue to bring comfort and reassurance.
For more resources on caregiving strategies and support, visit the Alzheimer's Association website.
