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Many of us often make mistakes when communicating with people who are living with dementia. It’s a learning process, but here are a few key practices which may help you. Remember, those living with dementia have a disease and cannot control their behavior. Their reasoning and logic skills are impaired. Changing our approach can reassure them and reduce anxiety.

Try these tips for successful interactions.  Above all, empathize.

1. REDIRECTION

• Be patient. To redirect is to lead. People prefer to follow someone they trust and enjoy, not someone who frightens or shames them.
• Use a calm, friendly tone. Make sure your body language reflects your soothing words.
• Avoid arguing or using reason. Do not say “Mom, if you do that, you’ll fall!” People with dementia lose the ability to follow logic. This is not an effective motivator. It only makes them defensive, which is counterproductive.

1. VALIDATION

• Enter their reality. Validation works through empathy, building trust, and developing a sense of security. If they believe their Mother is still living, ask them to describe Mom rather than say their Mother died years ago.
• Acknowledge their feelings. Do not argue. Instead, acknowledge their frustration and fear. Let them know you recognize their anxiety. Start with, “That must be upsetting.” instead of, “You’re wrong about that.”
• Dealing with paranoia. Do not dismiss their comments with “That’s not true.” Instead say, “I’ll help you with that problem.”  Recognize that although hallucinations can be disturbing, they are very real for those living with dementia. Empathize and reassure.

1. FIBS/LIES

• Last resort. You must know your family member to know if fibs/lies will be helpful to reduce anxiety, help by redirecting them.

I knew a daughter who received multiple phone calls from her Mother daily.  “Have you seen my sweater?  Do you have my sweater?”. After a lot of frustration and multiple times of saying “No, Mom.”, she  finally just said, “Yes Mom.  I have your sweater.”  She said, “Ok” and hung up.

•  When therapeutic fibs don’t work. If a person is suspicious, do not use fibs/lies. They can cause an escalation in the situation and distrust in current or future interactions.

1. TRUTH

• Share the truth. We often try to protect those with dementia by not telling them the truth. Not sharing the full truth can be frustrating and lead to agitation. Sometimes, calmly telling the truth can help the person. Communication practices should take into consideration the stage of dementia.
• The truth is better. In early stages of dementia, the truth is better.
• When the truth is better left unsaid. If what you share with them will only make them sad or experience emotional pain they will not remember later, it is not always best to be truthful. It’s not helpful to make someone re-live sad moments by being truthful.  In these cases, try to change the subject.

A FEW MORE TIPS

• What might be causing the behavior? Are they uncomfortable? Are they in pain? Thirsty?
• What caused the behavior? What did you learn that will help for next time? How did you respond? What did you do right? What might you try next time?
• Allow free-will. Do not restrict or try to stop a behavior unless it is harmful. Use the techniques above to prevent harm.