GUIDELINES FOR COMMUNICATION: to a person with Alzheimer Disease

BEFORE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE:

  1. Know the older adult first! (know their likes, dislikes and names – the name they like to be called).
  2. If you are a caregiver, read their chart or history. Are they a morning person or are they up at night? Know as much about them as you possibly can.
  3. Think about how you are presenting yourself
  4. Try a CALM, gentle, matter of fact approach
  5. Use a non-demanding approach – try humor, cheerfulness
  6. Try using a gentle touch, from the front (if appropriate) to communicate your message
    Begin the conversation socially (i.e., “Hi, my name is Michelle”). Use your name often and wear a nametag, if possible.

WHILE TALKING WITH SOMEONE WITH DEMENTIA OR ALZHEIMER’S DISEASE

  1. Approach from the front and talk to the person in a place with no distractions. It may sound obvious, but make sure hearing aids are turned on and have batteries.
  2. Begin by identifying yourself and addressing the person by the “best” name
  3. Look directly at the person and make sure you have his/her attention
  4. Make sure you are at eye level with the person (not looking down). Get at their level.
  5. Speak slowly and say words clearly and in a soft low pitch voice – gentle tone
  6. Ask only one thing at a time and do not rush
  7. Use short, simple sentences and questions (e.g., “are you cold?”)
  8. Use very concrete terms and familiar words
  9. Use actual names, instead of he and she, when referring to others
  10. Talk in a warm, easy-going, pleasant way
  11. Talk in a quiet, calm voice.
  12. Speak in positive terms
  13. Ignore harmless hallucinations or delusions
  14. Treat the person with RESPECT

WHEN YOU ARE HAVING TROUBLE BEING UNDERSTOOD

  1. Be patient; allow enough time
  2. Demonstrate visually what you are saying by pointing, touching or drawing
  3. Use short simple terms
  4. Be repetitive and consistent (if you need to repeat 3 times)
  5. Try a less difficult, more simple way to say it
  6. Try a hug and a change of subject
  7. Do not rush the person. Allow plenty of time for a response. If there is none, repeat the question, exactly as it was phrased the first time. If there still is no answer, reword the phrase.
  8. If possible, change who is asking the question or making the request. Someone else may have more success.

WHEN YOU ARE HAVING TROUBLE UNDERSTANDING

  1. Listen actively and carefully to what the person is trying to say
  2. Try to focus on a word or phrase that makes sense
  3. Respond to the emotional tone of the statement
  4. Experiment with supplying words
  5. Encourage the person to point or gesture
  6. Stay calm and be patient
  7. Ask family members about possible meanings for words, names, phrases
  8. Listen to their voice and gestures which may give clues to understanding

THINGS NOT TO DO

  1. Don’t argue and don’t give orders to the person.
  2. Don’t tell the person what he/she can’t do.
  3. Don’t “talk down” or appear superior to the person.
  4. Don’t treat them like a child.
  5. Don’t ask questions that require the person to remember facts.
  6. Don’t talk about people with the disease in front of them.
  7. Don’t use sarcasm or inappropriate humor. Alzheimer’s patients misinterpret humor.
  8. Don’t orient the person to person, place and time – validate their feelings and statements.

WHEN VERBAL COMMUNICATION JUST DOESN’T WORK

  1. Try distracting the person.
  2. Ignore angry or agitated statements if you can’t think of a positive response.
  3. Try other forms of communicating (songs, massage, favorite foods, walking, etc.)
  4. Give the person something to do. Try activities, a walk, giving them food or something to hold.
  5. Slow down!
  6. Again, try someone else. The Alzheimer or Dementia patient may just not like what you are wearing that day.
  7. Try again later.

COPING WITH CHALLENGING BEHAVIORS

  1. Build a positive, trusting relationship. You are familiar, you are safe.
  2. Use effective verbal and nonverbal communication techniques.
  3. Encourage independence in the person. Try to help the resident build a sense of control and competence over his/her life.
  4. Avoid arguing, yes/no battles, rational or logical explanations, and debates.
  5. Tell “therapeutic fibs” or “bent facts” to save a patient grief and reduce problem behaviors (i.e., validation therapy). Validate their hallucinations or delusions.
  6. Redirect or divert the person’s attention to a positive topic, activity, or object.
  7. When a behavior requires intervention, act quickly with positive techniques and activities.
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