Rates of dementia and other cognitive decline are on the rise in the United States which means communicating with the dementia patient affects most all of us. Today, 5.5 million people live with dementia caused by Alzheimer’s, and many others suffer dementia from other causes. Odds are, you have a friend or family member with dementia, possibly more than one.

Communicating with a person with dementia can be challenging, confusing and frustrating for your loved one and sad and even scary for you. Here are five tips for carrying on a conversation with someone with dementia.

  1. Approach with care and respect: Make sure you approach a dementia patient from the front. Many types of dementia, as well as the effects of aging, lead to diminished peripheral vision and hearing loss. A dementia patient is already navigating an uncertain world; startling him is no way to get the conversation going. Moving slowly from about 10 feet away, offer your hand and start speaking. If the patient doesn’t respond positively, extend a hand as well or greet you cheerfully, stay your distance until he is comfortable. Let the patient control your entrance into his private space.


  1. Once invited in, initiate gentle and appropriate contact: If the patient offers a hand, take it gently in your two hands, not squeezing, and be mindful of delicate, easily bruised skin. Depending on the patient’s mood and how close you are, you can keep holding hands throughout the conversation, gently stroking the patient’s hand or arm. Many dementia patients are soothed by human contact and crave it.


  1. Get down to the patient’s level, and look her in the eye: Don’t remain standing while your loved one sits. Kneel or pull up a chair on her dominant side (that is, the right side for a right-handed person). Make eye contact and hold it through the conversation.


  1. Let the patient tell the same stories again and again: When you visit someone with dementia, they will at some time start telling stories you’ve heard before, sometimes just a few minutes back. Go with it; this is his visit, and you should spend time in his world, where he’s never told that story before. Nod, smile, encourage him to talk but don’t press for details he can’t recall or correct detail he gets wrong.


  1. Expect the same questions again and again: Alzheimer’s and many other forms of dementia destroy the brain’s ability to form short-term memories. It is not that the patient can’t recall information you gave minutes before, it’s that she never registered it at all. So there’s no point in asking if she remembers (she can’t). Sometimes, when imparting information, it can help to offer some visual as well auditory input, for example holding up one finger while telling the patient “lunch is at one.” But chances are, for the most part, you’ll be answering the same question over and over. Just as in stories you’ve heard before, the best response is to give the answer again and refrain from criticizing or arguing about a memory the patient just does not have.

Spending time with a loved one with dementia can be a dispiriting and frustrating task, but it will be made that much more comfortable and more pleasurable for both of you if you keep the patient’s limitations in mind and meet her where she is that day and with patience and a smile.

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