Communicating with a person with dementia can be difficult as dementia progresses. Our good friend Rebecca had a hard time communicating as time passed, but because we knew her Life Story, we were able to bring forward memories and stories to help her feel in the flow of life.
We also knew she that she liked to express an opinion. She loved it when staff and volunteers at the Best Friends™ Day Center asked for her opinion, talked to her about the day, and showered her with hugs and smiles! They made her feel safe, secure and valued in spite of her communication challenges.
Staying connected and in the flow of life gets harder and harder as the ability to communicate declines or even vanishes. But even when the brain has been damaged, or aphasia and other difficulties impede communication, persons with dementia still want to communicate. They need us to keep trying with our words and actions.
These eight steps, drawn from the Best Friends™ approach, can help you stay connected to people like Rebecca.
1. Draw on the Life Story. Knowing someone’s Life Story is the key to good conversation. The specifics of the life story offer many topics and also help you communicate nonverbally in appropriate ways.
2. Go beyond words. Remember the power of smiles, enthusiasm, and hugs and handshakes, if they are welcomed. (The Life Story should tell you!) Body language communicates that you are a friend, someone approaching with a loving spirit. The writer Maya Angelou said it best: “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.” An upbeat tone of voice and lots of laughter can really make someone’s day.
3. Compliment, compliment, compliment. This powerful tool takes little time and costs no money. “Helen, you look so pretty in your pink sweater.” “Doctor, I can’t believe you delivered a thousand babies. You’re a hero!” Compliments reduce anxiety, fight depression, and cheer everyone up. Who can ever get enough?
4. Ask for an opinion. Asking someone for an opinion demonstrates that you value that person—and that opinion can be a simple yes or no. Ask a retired professor whether it’s worthwhile finishing your education, and you can evoke a vigorous nod. One staff member we know asks residents to choose her shade of lipstick each day. Even residents whose ability to communicate is slipping away can point or otherwise indicate their choice, and they love it when the staff person puts on what they chose. This simple activity evokes mother-daughter energy and conversations that friends have.
5. Thumbs up, thumbs down. Tracy Byrne, former assistant director of the Best Friends Day Center in Kentucky, has a clever way to communicate with a man who no longer speaks. “Steve, at 3 o’clock we’re gathering for tea. Thumbs up or thumbs down?” The simple yes-no question and the invitation to express himself delights Steve and gets an answer every time.
6. Give simple choices. Do you want to wear the red or the blue sweater? Should I wear the fuchsia or the pale pink lipstick? Any kind of choice helps people feel they have some control over their lives.
7. Take the blame. When things just aren’t going well, take the blame and apologize. “I’m sorry Joe, it’s me, not you, but I’m just not understanding. Let’s try again.” Follow your apology with a positive remark: “I’m glad we are still friends” or “I know you will forgive me since we are friends.” This can smooth over rough waters and restore happiness and calm to the situation.
8. Be affirming. If the person’s words cannot be understood, make an affirming statement like “Doug, I always enjoy being with you” or “Mom, you usually have all the right ideas. What would I do without you?”
Care partners need to make the effort to keep the person engaged in life. Even with communication losses, the person still retains a desire to communicate. We need to do all we can to fulfill this desire.