While there is no one-size-fits-all approach to communicating with someone with dementia, Henry says there are steps you can take to make your interactions as rich as possible. And there is one thing you must never do.
“We have to treat people with dignity and respect and never infantilise or talk down to them, because that can quickly make someone with dementia feel worthless,” says Henry, who works closely with, one of .
“It’s important not to make assumptions about someone’s ability to communicate either. In the early stages, you might not need to change your communication strategy. They might be as cognitively intact as anyone else just with some memory problems or personality changes (both common early signs of dementia). So it’s important to be led by them, to go with their flow – we call this a person-centred approach.”
Having learned firsthand what works and what doesn’t, these are Henry’s seven tips for speaking to someone with dementia.
1. Get your timing right
Try and tune into the person’s cycle, and recognise when they feel at their brightest. “The morning is often better as when someone with dementia gets tired, they often become less communicative,” says Henry.
If the person needs hearing aids or glasses, make sure they have them before you start your conversation and if they’re visually impaired, Henry advises approaching them slowly, from the front, and in a gentle manner.
Sitting in front of them, so they can see your face and make eye contact is equally important. “This indicates that the conversation matters to you,” says Henry. “Don’t rush them, and don’t fill pauses. It can take time for someone with dementia to process what you’ve said and formulate a response. Sometimes, they’ll disguise that by asking you to repeat yourself so go along with it and let them have time to think.”
2. Set the scene
“Making someone comfortable gives them a sense of tenderness, closeness and calm. If you create a feeling of security and empathy, that can really help the communication to flow,” says Henry. So, make sure they’re warm, comfortable and have had something to eat and drink. Turn off the television and get rid of background noise so that they only have one thing to focus on.
3. Adjust your pace and language
How much you have to modify your own speech is entirely dependent on the person in front of you, but in almost all cases, it’s wise to slow down and keep things simple.
Henry suggests asking questions one at a time, and making them simple ‘yes’ or ‘no’ questions, as this can stop someone from feeling overwhelmed. Think ‘shall we have a cup of tea?’, rather than ‘what would you like to do this afternoon?’
4. Be inclusive
Just because someone is less verbal these days, or seems to be less ‘with it’, doesn’t mean they should be excluded from conversations. “We’ve seen people talk over someone’s head, speaking to their caregiver when they should be speaking to the individual, or at least involving them in the conversation,” explains Henry. “People with dementia often feel worthless so making them feel heard is very important for their sense of value and identity.”
5. Avoid correction and contradiction
As someone’s dementia progresses, it’s common to forget big life events, like the death of a loved one. The person might mistake you for someone else, ask for a long-deceased parent or talk as if they’re back in their childhood or younger years.
“With dementia, someone’s timeline can be altered and they absolutely can’t help this,” says Henry. “It doesn’t cost us anything to play along and actually it might be helpful.”
If someone is asking where their dead husband is, telling them the truth will mean they have to re-live that shock and grief as if it’s the first time of hearing it. Far better, says Henry, to tell them that he’s at work or will be back later.
Arguing or criticising will only heighten someone’s confusion and cause them distress. “You can’t always reason with someone with dementia, and that’s not their fault.”
6. Use prompts and activities
“Music can be a really great tool in getting someone to open up,” says Henry. Sometimes, someone who’s almost entirely non-verbal might suddenly sing along to a song they knew in the past.
Anything that makes them feel connected to themselves can help. Someone who knitted throughout their life but can no longer do so might still find comfort in holding the wool and needles, and in turn, that can often prompt bursts of conversation.
Touch can also be very powerful when it comes to drawing someone into conversation. “Holding someone’s hand or giving them a hug, if appropriate, can help them feel secure and able to speak,” says Henry. “We sometimes start acting differently around people when they’ve had a diagnosis but try to relate to them as you did before. If that meant laughing and joking, that’s ok – in fact, it’s a good thing.”
7. Be open to change
Watching someone’s dementia get worse can be incredibly painful, but it’s important to change tack as the condition develops. “In the later stages, someone’s communication can entirely change – they might get angry or lash out through frustration. As carers, we need to understand what’s at the heart of that behaviour and usually it’s an unmet need that they can’t articulate.”
In those circumstances, it’s about using your empathy to tune into what they’re finding difficult about their situation in that moment. “Perhaps you’re having to help with their personal care and they feel embarrassed,” suggests Henry. The key, she says, is to look at the person in front of you and tailor your next move to what they need right now. It’s not easy, but in that moment, it will make the world of difference.
Race Against Dementia is one of four charities supported by this year’s Telegraph Christmas Charity Appeal. The others are Go Beyond, the RAF Benevolent Fund and Marie Curie. To make a donation, please visitor call 0151 284 1927