As a geriatric care manager, when I consult with  families whose spouse or parent has dementia, one of my first suggestions is to rid themselves of  the following words and notions : “logic, logical, logically even logicalizing.”  Simply stated, dementia is an illogical illness.

A quick example of logic gone awry.  Recently a son was telling me that his father was stepping into the waterless bath tub to shave. He would  not accept assistance and there were no grab bars on the tub walls. “I am going to tell him  it is not safe to do this,” he said to me.  To which I replied, “that approach is not going to work.”  A rather risky response, especially to a new client. I countered with a suggestion of putting some black or red tape across the floor of the tub with a note written in bold stating that the boards beneath the tub are loose and he should not step in. Okay, it’s an untruth, but “fiblets” are one of the most useful strategies in confronting Alzheimer’s disease.

While the above example is one of strategy, there are some guidelines for general communication with someone with Alzheimer’s Disease. By incorporating the six principles below and throwing logic to the wind, I believe a foundation can be established for maintaining or bettering one’s interaction with someone with dementia:

1. Speak slowly and calmly. People with dementia pick up on emotion. If you are upset or frustrated by the situation at hand, your parent will mirror you anxiety.  Pick a better time to have the conversation.

2. One sentence, one thought.  Keep your conversations simple.

3. Make eye contact. As senses become compromised, one needs to focus on the person. Eye contact in a quiet room without distractions will aid in effective communication.

4. If you are asking a question, ask just one question at a time.

5. Evaluate whether physical contact; holding a person’s hand, an arm around a shoulder, a hug or a kiss on the cheek will help or hinder a conversation.  Use this approach accordingly.  

Finally, the use of a “half smile.”  It is a just that, a semi-smile, take a look at Mona Lisa, she has the idea. It can reduce the stress of the caregiver and sets the stage for successful communication. As a geriatric care manager who often models herself after the Mona Lisa, or at least her smile, I invite you to learn more about the half-smile:
www.dbtselfhelp.com/html/half-smile_and_serenity.html