As a geriatric specialist, I am often confronted with the issue of communication in dementia, both in my own interactions with the people I see and in the form of questions (and often pleas) from their loved ones and other caregivers.
Communication with someone who has dementia can require a great deal of energy, patience, and creativity. I have learned the hard way that there a few “rules” that ultimately guide and inform most of the suggestions that may be offered. If you can learn and remember these two things, many of the others will follow naturally.
Rule No. 1: Don’t argue.
As painfully tempting as it may be, arguing only agitates you and the other person, potentially causing a whole cascade of additional problems. Further, neither of you can possibly “win.”Even if you succeed at somehow convincing Mom that she is wrong, she may not recall this even a few minutes later, depending on severity of the illness. And you’re back where you started.
Rule No. 2: Always Strive to Preserve Dignity and Respect
I often hear people with dementia referred to as having “the mind of a [insert age of a child here].” This always makes me a little nauseous. Yes, Dad may have “regressed” behaviorally. He may require assistance with self-care now, in some ways much like a child. But (and it’s a big BUT): He is an adult. He has lived an entire life, possibly even raising children himself. He deserves to be treated like an adult with dignity and respect.
Certainly, this can be more trying at times and there are some rather un-dignifying things that must be done in the care of someone with dementia. However, difficult things can still be conducted in a way that conveys respect for someone. Voice, gestures, and other reassuring mannerisms can help preserve dignity. The content of your speech may also convey respect–or not.
Finally, there may be certain activities or events that can preserve dignity and respect. For example, he or she can help tasks like etting the table, even if it’s not perfect; or folding the clothes, even if not perfect. People with dementia can continue wearing a watch or carrying a wallet or purse even if no longer able to tell time or keep up with a checkbook.
The person with dementia knows that she is not a child and she does not wish to be treated as such. The person with dementia deserves to not be treated as such.
The second rule forms the basis for the first, but the temptation to argue is so strong that it necessitated a first place listing. In general, if preservation of dignity and respect is the goal in a caregiver’s day-to-day decision-making and interactions, good decision-making and more pleasant interactions will follow.
Respect in challenging times is not always easy, and a main rule for caregivers in dealing with themselves is to avoid dwelling on mistakes and focus on the successes! Some days there will be more; other days there will be fewer. There is always tomorrow.
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