Dementia Care: Three Communication Mistakes

Senior Care in Long Island, NY

“The greatest enemy of knowledge is not ignorance.  It is the illusion of knowledge.” Stephen Hawking

Communicating with someone with dementia is very similar to learning a new language.  You must interpret what the person is saying in new ways that you never had to before and express yourself in new ways that the person can understand.  It also requires using more non-verbal forms of communication including body language, gestures, and facial expressions.

We often see family members struggling with communication because their role, as caretaker, requires a lot of decision making; and those decisions often need to be made without a lot of time to evaluate the situation and without enough information.  There are common mistakes we see families make when communicating with the person with dementia.

  1. Giving long explanations. The person with dementia has limited vocabulary and attention span due to the disease.  Make sure to keep your communication brief and to the point and cut out all the details.
  2. Giving the person a big decision to make. A person with dementia is not able to fully analyze an important decision.  Weighing out the costs and benefits, projecting possible outcomes, and calculating financials may no longer be within his or her functional abilities.  Giving the person smaller decisions to make along the way is a great way to respectfully keep him or her involved in the process.
  3. Accepting no as an answer. Dementia is a disease that often changes in its symptoms and its effects on the person’s functional abilities.  We often hear families say, “what worked yesterday is not working today” and vice versa.   When the person with dementia refuses to do something, that response could change at any given time.  And if you are getting a “no” response when it comes to a question about the personal safety and well-being of the person, consider the detrimental consequences of accepting that response.  There are times when family members have no choice but to take the driver’s seat.

It can also be difficult to tell what the person with dementia can understand and what he or she cannot.  Below is a helpful tool (provided by that lays out the stages of dementia and which abilities stay intact and which are lost.

Typically Lost  – Can’t Use Preserved—Can or May Use
Memory Damage

· Immediate recall, short term memory

· Clarity of time and place

· May not ID self or others correctly

Memory Skills

· Long term memories

· Emotional memories

· Awareness of familiar vs unfamiliar

Language Damage

· Finding the right word, describing

· Meaningful yes or no

· Socially acceptable expressions

· Communicating needs and desires verbally

Language Skills

· Desire to communicate

· Ability to use hands or action to describe

· Music and song

· Swearing, socially unacceptable words

Impulse Control

· Ability to demand respect

· Ability to control emotions

· Ability to control impulses

Impulse Control Skills

· Desire to be respected

· Ability to feel emotions

· Feeling badly about hurting someone

· May behave differently in public

Motor Skills and Sensory Processing

· Visual field is restricted

· May become hypersensitive to touch, sound, or light

Motor Skills and Sensory Processing

· The movement patterns for pieces of tasks

· Gross motor movements last longer than the fine motor skills



Jennifer Benjamin
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