Monday, November 18, 2013

Communication Skills When Clients Have Dementia

I was reviewing a paper for a friend recently.  The paper contained a reference to the work of the Arizona Center on Aging, in particular, their January 2013 release of an article written by Dr. Jake Harwood, who is with the Department of Communication at the U. of Az.  Dr. Harwood's article, Communicating with Patients Who Have Dementia starts by explaining the communication issues for people with dementia and how the different types of dementia have varying impacts on the communication ability of the individual. Dr. Harwood focuses mainly on Alzheimer's disease because the communication issues tend to be more pronounced in those individuals.  I found this paragraph particularly important:

People with dementia are often depersonalized, seen as less than human as a function of their age and functional impairments. As a result of low expectations, poor social environments, and poor communication, these individuals can end up with levels of disability that exceed what is attributable to their disease. The person inside is still capable of experiencing emotions, and capable of growth and new achievements. Their potential can be maximized by treating them as whole human beings, able to undertake meaningful endeavors.

Dr. Harwood offers ten tips for effectively communicating with individuals with dementia: keep the sentences simple, don't patronize, provide choice, don't rush, elaborate by saying the same thing with different words or rephrasing; repeat;  include the environment (or props) in the communication (such as pictures or music); use body language; be specific and concrete; and talk to the person-not at the person or to a 3rd party.

The article provides two tables-one for "effective verbal strategies" and the other for "effective non-verbal strategies".

Here is a quote from the table on verbal strategies:

  • Use Right Branching Sentences - put the main subject/object at the beginning of a sentence and avoid starting a sentence with subordinating conjunctions, e.g.: if, although, unless, as long as, because, before. For example, instead of saying “If you want to eat dinner now, please sit in this chair,” say “Please sit in this chair to eat dinner now.”
  • Avoid multi-clause sentences. For example, instead of saying “I went to the store and bought some milk and then stopped by to visit,” say “I went to the store. I bought some milk. Now I’m here to visit you.”
  • Use intonation to make intent clear, e.g., if you are asking a question, make sure it sounds like a question.
  • Encourage the patient to point and gesture by saying “Can you point to what you want?”

The non-verbal suggestions include the use of eye contact, physical contact, body position, facial expressions, demeanor, etc.

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