Meaningful Conversations with Someone with Dementia
Communication is simply the act of sharing information with one another. It might be an expression of a need, or a more complex conversation to share thoughts and ideas. People living with dementia often have difficulty expressing thoughts and feelings, either due to aphasia (unable to understand or express language) or because they are experiencing visual or auditory hallucinations, or episodes of delusions, where the person may believe something that is not true.
Conflicts and arguments can happen quickly when we fail to really understand the challenges that communication can bring for someone living with dementia. If we continue to use the same conversation skills that we have always used, the person with dementia may not understand those same skills. Because the connections between neurons in the brain breakdown, it is impossible for the person with dementia to remember facts accurately, or stop delusional thinking. They are physically unable to change their behavior, so we MUST change ours if we want to create an environment that promotes well-being.
Change is not easy, but a simple shift in our speech can result in helping the person with dementia feel understood, respected, and thus minimize the disagreements and frustrations that causes families so much stress and anxiety and begin engaging in meaningful conversations.
Below are simple changes we can begin to practice when interacting with our family member with dementia. Practice is the key word, because this does not happen overnight. But once you get the hang of the “new you,” your confidence will improve and you can tackle the harder things that come up much easier. The conversations may not flow as they once did or even make much sense, but when you witness the joy and appreciation your family member shows when you are sharing a meaningful conversation, you will be inspired to engage more often.
- Put your ego aside! This is not about you. If your family member thinks that he/she were married in 1982 instead of actually in 1942, let it go. The person may simply be wanting to enjoy reminiscing about the wedding. Facts are not important, but feelings are. Avoid correcting dates, places, or events, and just go with the flow and enjoy the time “conversing” about a pleasant memory with the person.
- You can repeat yourself, talk louder, demand for them to remember, or even scold them for asking the same question over and over, but it is impossible to make a person remember when they cannot. Memory loss is not just forgetting events, the person also has difficulty storing or retrieving memories, such as being unable to recall eating breakfast. Getting mad and showing your frustration can easily erupt into a disagreement.
- Take the word “remember” out of your vocabulary. If the person could remember they would, but when they are questioned if they remember something and they don’t, they feel shame, embarrassment, and sadness that they have disappointment you and are only reminded they have dementia. Just look at their facial expression next time you forget and question something they don’t remember. It is truly heart breaking.
- Take responsibility for everything! What is the big deal for apologizing for something you did not do when your family member who doesn’t even understand your reality anymore? If you ask your family member to get dressed for a doctor’s appointment and they get angry and claim you never told them about the appointment, just apologize and assure them you will tell them next time. If you are accused of taking your family members glasses off the nightstand, and you know they were left them in the bathroom, just apologize and explain you will look for the glasses.
- If your husband adamantly states that his mother is coming for lunch and his mother has been deceased for 20 years, reminding him of her death will only be upsetting. It would be as if he is hearing it for the first time. Often when someone forgets a family member has died and brings them up as if they were living, they are only wanting to think about and talk about that person. So when a loved begins talking about someone who has passed, just “recall” with them, something pleasant about the person and reminisce such as “oh, I can recall what a wonderful cook your mother is,” and the conversation will go in that direction.
These simple strategies will help create a more loving, compassionate and pleasant environment for your family member. Yes, it is very hard for us to apologize for things we didn’t do, avoid correcting a fact, or taking the blame to divert a conflict, but what is really important in life? It is so very important to let go of your agenda, and help your family member feel understood and accepted Perhaps we need to put more value in being kind and compassionate over the need “to be right.”
If you would like more information on our Memory Ministry, Memory Cafe, Virtual Support Group or Family and Friends Workshops we offer, please contact Vicky Pitner at vpitner@firstumc.org