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Dementia Communication

Enriching the Communication Experience for People with Dementia

Here are some simple and effective strategies to support communicating with people who have dementia. It’s as easy as remembering the word FOCUSED.

Face the person – maintain eye contact and say their name before talking.

Orient to topic – use repetition, use names, remind the person of the topic

Continue the topic – stay on the same topic of conversation for as long as possible, restate the topic, signal when you’ll change the topic (e.g., ‘Now we are talking about…’).

Unstick communication blocks – help the person overcome communication breakdowns and keep conversation flowing. Rather than ‘testing’ or correcting the person, provide help by clarifying e.g., Julie says to you ‘My mother came to visit’ you say ‘Oh do you mean your wife?’

Structure questions – use closed-choice questions (e.g., tea or coffee?), ask yes/no questions

Exchange conversation – encourage interaction- maintain conversation, be an active listener (e.g., ‘oh’, ‘uh-huh’, use simple comments), provide clues about how the person could respond (e.g. ‘how are you?’ ‘are you well?’)

Direct statements – provide short, simple and direct sentences, use specific names e.g. ‘Bob’ instead of ‘he’), use gesture and pointing to help the person understand.

Most to least effective strategies:

Research has shown that not all strategies are equal in usefulness. In fact, one strategy has shown to have a NEGATIVE impact on communication and therefore should NOT be used. Here we rank, as per research, most to least effective:

MOST EFFECTIVE:

Eliminating distractions (e.g., turn off TV and radio, have conversations in areas with limited background movement/actions (have conversations in quiet room rather than in busy, open space close to nursing station).
Provide simple sentences
Use yes/no questions

LEAST EFFECTIVE (AVOID):

Speaking more slowly. Research has shown this can have a negative impact on the interaction between the caregiver and person with Dementia. It is believed that due to speaking slower and making the length of the sentence longer, it requires greater working memory therefore more complex and challenging.

This is based on the caregiver training program FOCUSED which was created by Ripich, Wykle and Niles (1995). Aimed for nursing assistants working closely with patients with dementia.