As Alzheimer’s disease progresses, it can impact the way a person communicates. And we all know that communication is vital in the caregiving process. Alzheimer’s makes it difficult to express our ideas, feelings, and wants. In order to maintain a quality life, this basic need must be met.
Each person with Alzheimer’s disease is unique, as are each person’s communication abilities and deficits. An individual with Alzheimer’s may have trouble finding the right words, may misunderstand statements that are made, may repeat the same words or statements, or may revert to speaking a native tongue. As the disease progresses, caregivers may also see the person relying more on gestures than words. For example, it may be easier to point to an object such as a cup of water, than to ask for a drink. She may pat the sides of her waist to indicate she needs to go to the bathroom. Some people may have trouble speaking in cohesive statements, often with the phrases sounding more like “word salad”, an incomprehensible mixture of words or phrases. Consequently, caregivers must learn to rely on gestures and other forms of nonverbal communication in order to understand what the person is trying to communicate.
Despite the fact that communication may become more challenging as the disease progresses, sensitive ongoing communication is important. Although the person with Alzheimer’s may not respond to each statement, she still benefits from continued communication.
Here are some tips to enhance communication:
• Approach from the front and never from behind.
• Get eye-level and at a comfortable distance (at least 2 feet from face)
• Identify yourself by name (and/or role) and what you are going to do for/with the person. Even if you have known the person for years, it is still important to identify yourself and the task.
• Call the person by his/her familiar name.
• Use short, simple, one step instructions
• Give the person plenty of time to respond to questions and statements
• Limit available choices to two (2) for the person to decide from ( i.e. the blue dress or the red dress, a brownie or ice cream)
• Don’t ask questions that rely on memory (remember when you ate eggs for breakfast last week?).
• Speak in a strong clear voice; don’t yell unless the person has a hearing impairment.
• Don’t talk down or childlike.
• Turn negatives into positives. Say “Let’s go here” instead of “Don’t go in there.”
• Turn questions into statement. Say “Let’s go eat” instead of “Are you ready for lunch?”
• Be aware of your tone of voice. Convey an easy going attitude.
• Approach from the front and never from behind.
• Use positive, friendly facial expressions, even if you’re doing a difficult task.
• Be aware of your stance – avoid standing with hands on the hip or crossed arms.
• Focus on feelings not on facts.
• Validate feelings and help put those feelings into words.
• Be patient, flexible and understanding.
• If you cannot understand her, tell her, “I’m not sure what you’re trying to say, and we’ll come back to that later.”
Good communication will bolster self worth, validate feelings, stimulate memories, and calm and reassure.