Dementia

How to Interact with A Person with Dementia

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Dementia is a terrifying disease that most people don’t really understand. A person with Dementia may seem perfectly fine one minute but anxious or angry the next. They may greet a stranger as an old friend but see their own child as a stranger.

This makes interaction with a person with Dementia difficult. You never know what to expect so we often approach cautiously, guarded against the unknown.

A person with Dementia may not always understand words but they quickly pick up on body language and emotions. While you are approaching cautiously so as not to agitate your loved one, they perceive anxiety or even aggression.

There are ways to interact with a person with Dementia that will make the experience enjoyable for you both.

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Approaching Someone With Dementia

Approach your loved one with Dementia calmly and with a smile on your face. Always approach from the front. As you near, call out to them by name. Reach out a hand but let them determine the physical contact. Being too quick to hug or grab their hand will only frighten them particularly in later stages. If they make no move, gently touch their hand but be mindful of their own body language.

Related Post: Understanding Dementia Through Experience

1. Always have a positive attitude

While interaction with someone with Dementia can be intimidating, a positive attitude is a must. Give yourself a pep talk before hand. Remind yourself why you are here; to spend quality time with your loved one.

Keep conversation happy and upbeat. Talk about what they know. Reference the people and places from their past. Reminisce with them rather than remind them of what they’ve forgotten by telling a story yourself rather than using phrases like “do you remember…”. Visual aids such as old photographs are extremely helpful in keeping your loved one with Dementia engaged.

2. Avoid distractions

One thing that surprised me about my MIL is just how easily distracted she is. If there is any other activity or noise in the area, she will be immediately distracted by that and often completely forget what she had been doing or discussing.

While we’re going through our day, it’s difficult especially with the noise kids naturally add to an environment to keep distractions at a minimum.

My MIL often has trouble talking to me in the family room. She knows she needs something but with kids activities distracting her, she can’t communicate what she needs. We’ve made it a habit to retreat to the quiet of her room for our conversations.

If there is something important that needs to be discussed or if there are instructions that need to be followed:

  • Make sure the TV or radio is turned off.
  • Keep conversation focused and without interruption.
  • Maintain eye contact.

Related Post: How to Create A Home for Your Kids and Your Elderly Parents


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3. Keep it simple

While you always want to remember you are speaking to an adult, you also need to remember you are speaking to an adult whose brain is impaired. If you try to make conversation too complicated you will only confuse your loved one with Dementia and frustrate yourself by their lack of understanding.

– Use easy to understand language.
As a mom who spends the bulk of her day with small children, it’s easy for me to keep my language simple with my MIL as well. When speaking to my MIL with Dementia, I use the same language I use with my five-year-old. My tone is one I would use with any other adult but my vocabulary is simple and clear.

– Avoid unnecessary questions.
With my children, my goal is to get them to think for themselves. Oftentimes, when I know they are acting without thought, I will ask them questions leading them to determine what their action should be. My MIL’s mind is dying because of her Dementia so these kinds of rhetorical questions only serve to confuse and anger.

Other unnecessary questions would be:
1. Asking them to remember something
2. Decisions that are non-negotiable (hygiene, appropriate clothing, diet, medication, appointments, etc.)
3. Ironic questions such as “Don’t you think you should…?” or “What do you think you should do?”

– Don’t try to be sarcastic or ironic

Oftentimes we like to diffuse difficult or uncomfortable situations with sarcasm or irony. Usually, it’s in an effort to be funny and lighten the situation. Our loved one with Dementia no longer has the ability to discern sarcasm. So your words meant as a joke will be taken literally.

4. Be willing to repeat yourself

It can be really frustrating as a caregiver to constantly have to repeat yourself. Always keep in mind that for your loved one with Dementia, your response, whether it’s the first or the fifth, is the only response they recall. They will not understand a harsh answer if you answer out of repetitive frustration.

5. Be respectful and avoid infantilizing

The thing my MIL wants most in this world is to be “normal”. She knows something is different. It’s scary and confusing and the last things she needs is someone treating her like a child.

Every time my sister-in-law visits we go to Red Lobster. Because of her Dementia, my MIL needs someone to order for her. She has to be reminded multiple times that she has ordered and her food is being prepared. We have to tell her over and over again that she is indeed getting lobster.

My MIL has no ability to manage money but she wants everyone to know that SHE is paying the check. While her name is still on the account, she does not hold a single bank or credit card in her name.

What I love the most about this is almost every time my sister-in-law lets my MIL hand the waiter the credit card and sign the receipt. My sister-in-law never says, you don’t do that anymore or you can’t, she just hands her the card when asked. My MIL gets this tangible validation that she’s still an adult with adult privileges.

It’s HARD to do when their brain causes such childlike behavior. It’s HARD when you are managing almost every part of their life. But it’s so important!

Be respectful of the life they lived – jobs, marriage, children, grandchildren, hobbies, likes and dislikes – before this disease took over by giving them the courtesy of being treated like an adult.

6. Touch and body language is important

Dementia is terrifying but it is not contagious. Treat your loved one tenderly. Hold their hand. Give them hugs. Touch their shoulder. Let them know you love them. Be expressive, but not overbearing with your hand motions as you speak.

7. Tone matters

It was a difficult phone conversation with more conflict than I prefer. I felt stressed and a little angry that I had to confront this person on the other end of the phone line.

My MIL called me into her room. She needed me. As soon as my phone conversation was over, I went in to her room to help.

As I entered, I sighed, still recovering from my phone conversation, and said my usual, “Yes ma’am.” My tone was tired and frustrated. Her response cut me to my very core.

“Please don’t be angry with me.”

I was not at all angry with her but she had no way of knowing that. My tone was one of annoyance and it immediately caused her concern and anxiety that she was the cause.

As difficult as it can be, you must keep your negative emotions checked when speaking with your loved one with Dementia. They will pick up on it but instead of causing them concern for you (the response of most adults), it will cause them anxiety and confusion about what they did to cause you to feel so badly.

8. Remember the “10 Commandments”

When interacting with your loved one with Dementia, there are 10 rules that will help you have a more meaningful conversation.

  1. Always agree, never argue
  2. Always redirect, never reason
  3. Always distract, never shame
  4. Always reassure, never lecture
  5. Always reminisce, never say “remember”
  6. Always repeat, never say, “I already told you”
  7. Always encourage independence, never say “you can’t”
  8. Always ask, never command
  9. Always praise, never condescend
  10. Always reinforce, never force

These rules of conversation will help you keep your loved one feeling confident and at ease throughout your interactions.

Related Post: How to Talk to Someone Who Has Dementia: 10 Rules of Conversation

9. Ease your expectations

Walk in knowing what you are dealing with. They WILL repeat themselves. You WILL be asked the same question a dozen times. They may or may not know who you are or why you are even there.

If it’s been a while since you have seen your loved one with Dementia, have a conversation with the primary caregiver about where they are in the disease and what you might encounter. If you go in knowing as much as you can about your loved one and their Dementia, you will feel much more confident about your visit.

Expect nothing from them. When your expectations are high, you will almost always leave disappointed.

It’s natural to desire that your loved one with Dementia to be the person you remember. The reality is, that most likely will not be the case. You may catch glimpses of who they were, but you mustn’t expect them to be that person. You will be disappointed and your loved one with Dementia will only be more confused.

10. Sometimes it’s not what you say

The most important thing we need to remember when we’re interacting with our loved one with Dementia is, even though they may not have the ability to show it, your PRESENCE matters!

There are many times when my MIL knows I’m busy doing something but she doesn’t want to be alone. She’ll ask, “Is it ok if I sit in here with you?” My answer is always yes but it is a good reminder to me that being in the presence of those that care for her and love her is extremely important to her. It is validation that she is not walking this terrifying road alone.

If you are finding conversation with your loved one with Dementia difficult, then just be there with them. Don’t force interaction. Try reading aloud from a book, sitting next to them watching a favorite TV show, or flip silently through a few pictures. The important thing is that you took the time to be there and whether they can express it or not, that matters to them.

As terrifying as Dementia can be from the outside, remember that your loved one is also frightened. They are aware of changes happening in their mind.

The worst reaction you can have to your loved one with Dementia is to stay away. Put aside your excuses of wanting to remember them like they were or not wanting to cause them more confusion. Take courage and be strong because your loved one with Dementia needs you now more than ever.

Did you like this post? What ways have you found to successfully interact with your loved on with Dementia? Let me know in the comments below.

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