A Caregiver's Guide to Compassionate Communication
August 13, 2015
Language forms the basis of how we communicate with each other. Words express how we feel about others, ourselves and what we’re experiencing at the moment. But what happens when words fail us? When we no longer remember the right words for everyday things, when people’s names are gone from our memory, when we can’t tell someone that we are in pain?
Caring for someone with dementia can be daunting, especially when it comes to communication. As the disease progresses, the person’s ability to use language in the way we expect gets jumbled and slowly fades away. They struggle with words that don’t come out right, not remembering things from one minute to the next, not knowing what to do next. The person’s experience of the world and their relation to it has changed forever.
For family and caregivers, adopting attitudes of compassion and understanding can go a long way to relieving the inevitable frustration that both sides often feel. Experts in dementia care encourage families to meet their loved one in their “reality” – whatever or wherever that might be. Trying to bring them into our present reality is often difficult and stressful both for the caregiver and the person with memory loss.
When you're actively caring for someone, it can be hard not to take a parental tone that sounds condescending and disrespectful. It can make the person you’re caring for feel like a child. Watch your tone and word choices, and try to speak to your loved one as an equal whenever possible.
When the person exhibits difficult behavior, see it as an expression of an unmet need. They’re using their limited means of communication to tell you that something needs attention. The words aren’t likely to come out as intended so be a detective. Is it too hot or too cold, too noisy, are they in pain? Take your loved one’s distress seriously, just not personally.
Set your loved one up for conversational success by replacing open-ended questions with ones that are easier to answer. For example, says something like "Mom, tell Kathy how much you enjoyed raising your five children," instead of "Mom, tell Kathy how many children you have."
Be realistic about what constitutes success during the progression of the disease. Most people with dementia have good days and bad days. Try your best to foster the good days and even the good moments.
See the person as still being a whole person. Operate from the premise that he or she is still very much there, no matter what it may look like from the outside. Don’t expect anything and welcome the surprises when they come, as they often times do with persons with dementia. A smile, a word, a sentence, singing an old song -- you never know.
Meet the person in their reality, and join them. Keep them safe, but not in such a way that they feel like prisoners. Give them choices, but not too many so they don’t get overwhelmed. Structure their days, so that they don’t have to face too many blank moments. Don’t shame them for talking in ways that don’t make sense to you.
The journey of dementia is never easy, but understanding new ways to communicate with our loved one can make it a more compassionate passage.