Adria Thompson, a speech-language pathologist and dementia care educator, shares the small communication shifts that can transform daily caregiving moments.
What’s one simple communication shift that can immediately improve interactions between caregivers and someone living with dementia?
One simple communication shift that can improve interactions between caregivers and individuals living with dementia is to use fewer pronouns in their speech. Pronouns like he, she, it, that, those, and these refer back to people, places, and things mentioned earlier in the conversation. When someone with dementia experiences short-term memory loss, they may not have the memory to recall what pronouns are referring to.
For example, let’s say during a conversation a person says, “I saw Bob earlier today at the coffee shop. I hadn’t seen him in a long time. He says he goes there every week. It’s so strange I haven’t seen him there before.” By the end of that sentence, a person with dementia may not know what “him” or “there” refers to. This makes conversations much more complex than necessary.
What are caregivers often doing unintentionally that may increase confusion or distress, and how can they adjust in the moment?
Caregivers will often respond to someone with dementia declining care by explaining, arguing, or trying to convince them it’s necessary. This is a very reasonable response. After all, it’s important that individuals with dementia do things like take a shower, change their clothes, and go to the bathroom.
However, when caregivers provide explanations to a person who has lost the ability to reason, is experiencing short-term memory loss, and may not understand that they need help, it often is not effective. This can cause increased distress and confusion.
A small adjustment a caregiver can make in tough caregiving moments is to pause and listen. Taking objections seriously can provide insight into why they are resisting. This is the first step in building trust and finding a more creative, supportive approach to completing care tasks.
What are small, practical changes in daily routines that can help reduce resistance or agitation?
A small practical change in daily routine that can help reduce resistance or agitation is to get a person with dementia in the space where the care task will happen before initiating it.
For example, if a person with dementia is sitting in the living room when a caregiver comes up to them and says, “It’s time to take a shower. Let’s go!” it may feel very disorienting. Context plays a huge role in understanding. A living room doesn’t signal bathing and can lead to resistance.
Instead, a caregiver can say, “I need some help fixing a leaky faucet,” or “Come help me pick out which earrings to wear to dinner tonight,” in order to get them to walk into the bathroom. Once in the space, they can gently transition: “While we are in here, I’ll turn the water on for you, and you can rinse off.” Being in the right environment first can be essential in reducing resistance and agitation.
How can caregivers better manage their expectations as the condition progresses without feeling like they’re losing connection with their loved one?
Unmet expectations are a major source of frustration and disappointment. This is especially true in caring for someone with dementia. When caregivers believe that a person with dementia should behave in a certain way or should be able to perform certain tasks, they are often disappointed and frustrated.
The most important way to adjust expectations is through education about how dementia progresses and impacts daily function. Because these changes evolve over time, expectations need to be revisited often. Seeking out reputable education and support can help caregivers better understand what to expect and how to adapt, allowing them to stay connected while providing care.
What do you wish more people understood about how dementia changes the way someone experiences the world?
It’s incredibly important for people to understand that everything someone with dementia does makes sense to them.
Are they resisting the toilet? Picking at the floor? Believing something has been stolen? To them, these actions are logical. Holding onto the belief that “everything they do makes sense to them” can be a powerful shift in perspective.
When choices of individuals with dementia are simply perceived as nonsensical and unreasonable, it’s easier to jump to feeling frustrated. However, when we assume there is a reason, even if we don’t understand it, it creates space for curiosity and compassion.
