Carers' Corner

Dementia (communication skills)

Dementia is a clinical syndrome involving a continual and gradual loss of intellectual function, leading to cognitive impairment and memory loss. Patients have difficulty in communication and self-care in their daily lives. If carers do not have clear understanding of the illness, they may feel very frustrated about the communication blockage.

Factors leading to communication problems:

1. Patient's factors:

• memory loss and difficulties in retaining information

• difficulties in carrying out complex tasks due to cognitive impairment

• low concentration span

• mood swing and increased level of irritability

2. Carer's factors:

• speaking too fast or in a high-pitched voice, causing stress to the patient

• too much information; or unnecessary gestures which may be misleading and distract the patient's attention

• too tired, feeling frustrated and inpatient

• improper tone of voice, e.g. shouting may cause patient to feel threatened and offended

3. Environmental factors:

• noisy environment

• poor lighting

Ten keypoints for good communication:

1. Maintain a quiet environment; turn off radios or televisions if necessary.

2. Sit face-to-face with the patient, and try to maintain eye contact at all times.

3. Speak slowly and clearly. Encourage the use of hearing aids in patients with hearing problems. Do not shout at the patient. Try not to raise the voice.

4. Keep the sentences as simple as possible. Convey one message at a time. Avoid the use of certain terms such as he/she/it, and use names instead. Avoid words with abstract ideas, e.g. replace the terms 'hungry' and 'thirsty' with terms like 'eat' and 'drink'

5. Ask one question at a time and keep questions simple. Ask close-ended questions with limited choices such as 'Would you like an apple or an orange?' instead of asking 'What types of fruit would you like?'.

6. Pay attention to facial expressions and body languages to interpret the patient's feelings, e.g. is the patient smiling or wincing in pain? Respond to patients' feelings accordingly, e.g. nodding and smiling can be signs of encouragement to the patient.

7. Repeat yourself or prompt the patient if necessary.

8. Use real objects to aid communication. For example, show the patient a towel and soap to indicate it is time for a bath.

9. Conversations should be kept concise as patients have difficulties in concentrating for long periods.

10. If the patient is tired, pat him on the shoulder or hand over a drink for refreshment. Take a break before starting again

Summary

Apart from these ten points, a good understanding of the disease and a caring attitude are also important in achieving the best result in communicating with demented patients.

Related topics

Dementia

Behavioral Management in Persons with Dementia

Activity Program for Persons with Dementia

Dementia - Daily Living

Reference :

Resource Book on Psychosocial Health Promotion in the Elderly (Traditional Chinese Only)