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Communicating with Someone
with Dementia

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Dementia is a term that describes disorders of the brain resulting in a gradual decline of mental ability. It can affect memory, judgment, decision-making, language skills as well as a person's mood and personality.

An early sign of dementia is trouble with finding words: being unable to retrieve the names of people, places or things. People with early signs of dementia may misinterpret attempts at communication and misunderstandings can occur.

Alzheimer's disease is the most common form of dementia. It is a progressive, degenerative disease of the brain.

Tips and Tools for Communicating with People with Dementia:

When listening:

• Listen carefully and offer encouragement.
  
• Think about how things appear in the reality of the person with dementia.
  
• If the person has trouble finding words, listen for clues. Encourage the person to explain in a different way, if possible.
  
• Pay attention to the person's body language.
  
• Sometimes the best thing you can do is listen and show you care, even if the person is sad or confused.

When speaking:

• Make eye contact and make sure you have the person's full attention before you speak.
  
• Use physical contact, if appropriate, to reassure the person.
  
• Show respect and patience. It may take longer for the person to process and respond.
  
• Be calm when you communicate. Agitated movements or tense facial expressions may upset the person.
  
• Always respect the person's personal space. Standing too close may be intimidating.

As the person with dementia progresses …

• It may be more difficult for that person to initiate conversation.
• Fact and fantasy can become confused. Try to avoid contradicting what the person says.
• Provide short chunks of information.
• Avoid asking direct questions. People with dementia can become frustrated, irritable or even aggressive if they can't find the answer.
• Processing information will take longer, so allow extra time.
• Humour can bring you closer together and help to relieve tension.

Tips and Tools for Therapy Dog Teams

• Double leash walking can be an enjoyable pastime for some people with dementia, providing the environment is safe for them.
• Talking to people with dementia about their own pets can help bring back memories from the past.
  
• Games of ball or doing tricks together can be fun leisure time activities for some people with dementia.
  
• Always have an exit plan with your dog should the person with dementia become angry or aggressive.
  
• If you don't know the patient, be careful about coming too close during an initial visit, just in case the person becomes scared or aggressive.

For more information on wheelchair etiquette, check these useful web sites:

Alzheimer Society of Ontario at www.alzheimerontario.org

Prepared by Julianne Labreche, a speech-language pathologist in adult rehabilitation and associate member of Ottawa Therapy Dogs (OTD); Carole Eldridge, Chair, OTD; and Julie Ferguson, a recreation therapist in the field of mental health.

OTD Toolbox Infosheet #3