Memory and intellect deteriorate as dementia progresses, yet people with dementia continue to interact. How staff respond can have profound effects on a person’s wellbeing.
Barriers to communication may relate to individual issues or to social and physical environments. Personal barriers may include:
- health status
- physical ability
- cognitive and sensory ability
- emotional wellbeing
- personality and mood
- culture and knowledge of English.
- A facility’s institutional values and philosophy affect the social environment through policies on:
- staff recruitment and training
- staff-to-staff communication
- staff–resident ratios
- staff encouragement and support.
In the physical environment, communication is affected by:
- building design and layout
- size of rooms
- size and placement of furniture
- width and length of corridors
- extent of private space
- ambient noise.
Change: As dementia progresses adjust how you communicate to suit a person’s changing needs.
Context: Guide a person through any task, activity or request by explaining or describing what is happening or about to happen.
No expectations: Make it clear verbally and non-verbally that a person may respond or not as they wish; that nothing is required of them.
Reassurance: Communicate verbally and non-verbally to reassure a person they are accepted.
Consistency: Verbal responses and non-verbal communication should not contradict each other.
- Talk to a person, rather than about them to others.
- Address a person by their preferred name, not ‘dear’ or ‘love’.
- Tell a person what you are doing or going to do.
- Focus your full attention on the person and make eye contact.
- Use words and sounds of encouragement.
- Do not use a demeaning or condescending tone of voice or hostile gestures or stance.
- Do not invade a person’s personal space.
- Speak at a slower pace.
- Pause between one topic and the next.
- Use prompts such as pictures, photographs and simple signs.
- Accept a person’s feelings.
- Use non-threatening physical contact.
- Do not make abrupt changes to routines.
- Get to know a person’s life story so you have a store of background information for questions and conversations.
- Use individualised memory books to improve and keep communication skills.
- Use written and pictorial signs in significant places around the facility.
- Place memory charts containing photographs, brief statements about the person and conversation topics on bedroom walls and other appropriate places to aid communication.
- Use other techniques and therapies that help communication like aromatherapy, attention focusing, bright light therapy, massage, music therapy, pet therapy, reminiscence sessions and walking.