Avoiding Argument and Confrontation
One of the most counterproductive actions when communicating with someone with dementia is engaging in arguments or confrontations. Their reality is different, and correcting factual errors will only lead to frustration, agitation, and distrust.
The futility of reasoning and correction
As dementia progresses, the ability to reason logically diminishes significantly. Attempting to use logic to win an argument is not only ineffective but can be emotionally damaging. For example, if a loved one insists that their deceased spouse is still alive and at work, telling them they are wrong can cause renewed grief and confusion. Instead, acknowledging their feeling—"You must miss them very much"—can be a more compassionate and soothing approach.
Prioritize emotion over fact
The underlying emotion is what is real for the person with dementia. Their feelings of anxiety, sadness, or confusion should be the focus, not the accuracy of their statement. Validating their feelings shows respect and empathy. If they are insistent on a story that is not true, gently redirect the conversation rather than insisting on the facts.
The Problem with Memory-Testing Questions and Reminders
Asking questions that rely on recent memory or reminding them they have forgotten something is a primary pitfall for caregivers. This can lead to embarrassment, anxiety, and a sense of failure.
Common mistakes that trigger distress
- Asking, "Do you remember?": This can feel like a pop quiz, highlighting their memory loss. It can provoke feelings of shame and inadequacy.
- Stating, "I just told you that": This comment adds insult to injury by pointing out their cognitive deficit. The repetition is not their fault, and they likely do not remember the previous conversation.
- Asking questions with too many options: Open-ended questions like, "What do you want for dinner?" can be overwhelming. Instead, offer a simple choice, such as, "Would you like chicken or fish?".
What to do instead
Focus on present-moment engagement. Instead of quizzing, share your own memories or guide them with visual cues. If you want to talk about a past event, frame it positively: "I was just thinking about that wonderful trip we took to the mountains."
Avoiding Complex Language and Rushing the Conversation
Dementia affects the ability to process information quickly. Using long, complicated sentences or rushing the person can hinder communication and increase stress.
Simplify, slow down, and be patient
- Avoid complex sentences: Break down instructions into single, easy-to-follow steps. Instead of, "Let's go get your coat, then we'll find your keys and leave for the store," try: "Let's get your coat".
- Give them time to respond: A pause in conversation can feel awkward, but it is necessary for someone with dementia to process what was said. Do not interrupt or finish their sentences.
- Repeat yourself calmly: If they don't understand, repeat the same words and tone rather than rephrasing, which can cause more confusion.
Refraining from Patronizing Language and Behavior
Talking down to someone with dementia is both disrespectful and isolating. "Elderspeak," or baby talk, strips them of their dignity and can be picked up on even if the words are not fully processed.
The dangers of infantilization
- Using pet names: Terms like "honey" or "sweetie" when you normally wouldn't use them can be demeaning. Use their preferred name or title instead.
- Excluding them from conversations: Do not talk about the person as if they are not there, even if you believe they can't understand. Always include them and speak directly to them.
- Ignoring their feelings: Assuming they don't have emotions or can't be hurt is a grave error. They are still people with feelings that should be respected and acknowledged.
Comparison of Effective vs. Ineffective Communication
| Ineffective Approach | Effective Approach |
|---|---|
| Arguing facts | Validating emotions and redirecting |
| Testing memory with questions | Engaging in the present and past with cues |
| Using complex language or commands | Using simple, one-step instructions |
| Being impatient or rushing them | Allowing plenty of time for processing |
| Using patronizing language | Speaking with respect, at eye level |
| Excluding them from a conversation | Including them** in interactions |
The Takeaway: Connect, Don't Correct
The most important principle is to shift your focus from correction to connection. The person with dementia is still a human being with a history, feelings, and a need for respect. While their cognitive abilities may be changing, their emotional capacity and desire for human connection often remain. By avoiding these common communication pitfalls, you can reduce their frustration and create a more compassionate and supportive environment.
Communicating with someone who has dementia requires patience, empathy, and a willingness to adapt your approach. As a loved one or caregiver, your presence and your calm demeanor are often more important than the words you say. You can find further resources and support for caregivers from the Alzheimer's Association. By remembering what not to do, you can build a more meaningful and positive relationship with the person you care for, navigating the challenges of dementia with greater understanding and warmth.
