Increasing Communication With Residents Who Have Dementia

Listening to another person without a focus on words, as well as how to understand the differences that exist between communicators in processing information is an important aspect to understand when caring for residents with dementia.

According to dementia expert Kerry C. Mills, MPA, author of Serving Residents With Dementia: Transforming Care Strategies for Assisted Living Providers, there are eight steps to integrating effective speaking practices with other essential aspects of communication.

This excerpt from her book will review two of these steps, which highlight the importance of preparation.

1. Prepare yourself

Prime yourself and your own mind for this more robust method of communicating. If your dog ran away before leaving for work, traffic was a nightmare, you had a fight with your spouse, or you are anxious about a meeting today, leave those emotions at the door. A person with dementia is going to pick up on your emotions and your overall state of being rather than just the words you are saying.

Put on a smile, shake hands or hug the residents, say good morning, and tell them a funny story. If you are unable to shake your problem, let them know. “I am sorry Susie. I am having a hard day today because my teenager is acting quite rebellious, and I am worried about her.” Confiding in Susie lets her know that you recognize your own anxiety and that it has nothing to do with her. Furthermore, don’t be surprised if Susie responds with advice, a kind word, or a hug that helps you feel better.

In addition to opening yourself to the idea that residents with dementia can have distinct personalities and impeccable perceptions, as well as share meaningful insights, you must also be patient with their limitations. Understand that certain individuals can’t help but repeat themselves, avoid taking it personally if someone says that you look tired today or are putting on some weight. If you have taken the time to prepare yourself, you will be a better position to work with the residents.

Evidence from the real world:

One summer, I had to drive about two hours to work on Monday mornings. To say the least, I was quite tired when I arrived, but I always tried not to look it when I joined the residents. This one particular morning, after I had spent about 10 minutes with the residents, I turned to leave, and Judith, one of the residents, said to me, “You know dear, you are just beautiful.” Then, with a wry smile, she added, “You know I am legally blind.” Her genuine compliment—tempered with her signature wit—gave me a surge of energy.

2. Prepare the residents

Regardless of our intentions, our reflexive ways of interacting with people who have dementia sometimes put them on the spot and cause them to become defensive or, worse yet, to feel embarrassed or incompetent. Doing our best to ensure not only that we understand where residents are coming from, but that they do the same fosters more successful communication by both parties.

For example, introduce yourself by stating your name, rather than asking residents to supply it—an approach that suggests companionship rather than a veiled attempt to test memory. In turn, address residents by the name they prefer to be called, along with the gesture to which they are accustomed (e.g., a handshake, pat on the back, kiss on the cheek, or hug). If we set the residents up to succeed, they will have more confidence and feel better about themselves.

This is the first in a four-part series. Check in next week for Part 2 of increasing communication with your residents who have dementia, which will reveal best practices for approaching residents who have dementia, and how to ask questions to engage, rather than test them.