While communicating with someone with MCI, dementia, and other types of memory loss can be challenging, the appropriate approaches can help bridge some of those gaps.

And you’re not the only one facing challenges like this. The number of Americans with Alzheimer’s disease is steadily rising; anyone caring for an older adult can be impacted and need to learn how to deal with the situation.

Everyone who has dementia experiences it differently; therefore, it’s crucial to communicate in a way that is appropriate for them. When talking to anyone, the most important thing is to pay close attention to them and what they’re saying — and that will always come before any third-party suggestions or guides.

What dementia does to the brain

Dementia physiologically affects different brain regions; more specifically, it alters the brain in a way that makes it challenging for people to learn and retain knowledge as it damages the temporal lobe. You may notice that your dementia patient can remember events from long ago for a while after the disease has begun. Even though they can remember wedding dates or the high school they attended, they may not remember your visit from the day before.

They can retain memories of events that occurred long ago because those memories are represented throughout the brain. Long-term memory is likely stored in several systems across the brain, not just one or two. Therefore, it takes a severe case of the disease for patients and loved ones to begin losing those core memories.

Things to consider before communicating

Make sure you’re in a good communication environment. It should be peaceful and quiet, with adequate illumination — body language and expressions go a much longer way when words may not be sufficient. Muting the radio or turning off the TV is a good idea when speaking to someone with dementia.

Before you begin, see that the person’s other needs are satisfied, such as making sure they aren’t hungry or tired.

If the individual can speak more clearly at a particular time of day, use that time to discuss important topics or any questions or concerns. Make the most of “good” days and learn to adjust to the challenging ones. Just as we all have ups and downs, an individual with dementia may find communicating much easier on certain days compared to others.

Common difficulties & irritants

You can reduce frustration when you interact with patients and loved ones compassionately and encouragingly. Knowing some frequent frustrations and “traps” and how to avoid them is vital if you’re having trouble connecting with a patient or loved one with memory loss.

Remember that those with dementia or Alzheimer’s often can only experience the moment at hand, allowing us to express how much we value their company. The patient’s feelings should always come first when caring for someone with an illness. A person with memory loss sometimes cannot recall the previous minute and is unaware of what will occur the following minute. The most crucial thing to pay attention to right now is how they feel as their sense of the past and future may be weakened.

Interactions will go more smoothly if you have their feelings as your compass. It can be a lot simpler to make decisions if you think, “I want them to feel protected and respected,” or, “I want them to have a wonderful time.”

What to do while communicating

Speak clearly and give them your attention

Make sure that the patient knows they’re being seen and heard, even if you’re having trouble understanding them. Maintain eye contact, don’t try speaking to them while working on something else, and invite them into conversations with other people. Speak clearly when addressing them, and don’t express frustration if you’re having trouble understanding them.

Streamline your sentences.

Use straightforward and short sentences, then rephrase using the same language if necessary. Limiting questions to one or two sentences is best, and “yes” or “no” answers are preferable to open-ended or multiple-choice questions. Don’t give more than one direction or question at a time to a patient or loved one. If they still have trouble understanding, visual cues can help.

Remember that memory loss isn’t zero-sum

Other physical illnesses (lung, heart, pancreas) are tested for, but memory loss is frequently treated like a switch: “Either they got it, or they don’t.” Memory loss progresses just like everything else. Thus it’s up to the family member or caregiver to locate the patient and loved one and support them.

What not to do while communicating

Avoid correcting them

As we’ve said, memory loss is progressive, and with that, language retention is too. When your care recipient talks to you about a letter they got, they may struggle to say the word “envelope” or point to a lamp but struggle to say the word “lamp.” It becomes challenging for the person to find the precise, appropriate term to describe what they want to say when their language becomes disfluent. Be patient with them, and do your best to follow along, asking gently for clarification when necessary.

Avoid provoking aggressive behavior.

Aggressive behavior can occur in dementia or Alzheimer’s patients in response to their surroundings. A person may become combative when being rushed, spoken to rudely, or forced. Aggressive behavior is a way for someone with memory loss to communicate. Of course, as a caregiver, you shouldn’t tolerate any abuse — but if your care recipient seems agitated, angry, or combative, try to figure out what might have upset them.

Please don’t belittle them.

Never use condescending language when speaking to someone with dementia or Alzheimer’s. Speaking to your care recipient like a four-year-old will not help just because they are having language difficulties. Avoid speaking in an exaggeratedly slow manner out of frustration as well, and don’t speak dismissively to the care recipient —for example, offhandedly addressing them in a conversation about them, without including them in it beforehand. In general, you should make your best effort to include the care recipient in any conversations involving them while they are around.

Conclusion

Our most complex organ, the brain is still something we don’t completely understand. While a person who has dementia might not be able to remember what they had for breakfast that day, they might be able to recall people, places, and events from a long time ago. Remember to ask the patient or loved one about their favorite childhood stories or past memories; you might be surprised at what they can recall, and what you learn.

Remember that even as an individual is losing their memories, they are still experiencing feelings and emotions. Be mindful of this and always look for the little ways you can communicate with your loved one as you once did. While it’s a challenging thing to do, the rewards of having an old joke land or relaying a good memory to them can be tenfold.

‍