As Dementia and Alzheimer’s diseases progress, they eventually diminish a person’s ability to communicate. This means to the person who has Alzheimer’s, communication becomes stressful. A different way of communication needs to be used along with verbal communication if verbal communication is still understood. This is where non-verbal communication comes into play.
The simplest and easiest thing to do is to touch your loved one. A caring gesture, as an example, is to take one of the person’s hands in both of yours. This type of hand holding is very reassuring. You can also touch a shoulder or back when serving food or just walking past your loved one’s chair.
Facial expressions have six basic looks: surprise, disgust, sadness, happiness, anger or fear. Often, we use combinations of these without even knowing it. So be aware of what your facial expressions are telling someone else. A person will believe facial expressions before words. So, if you’re serving lunch and say, “You’ll enjoy this,” but make a disgusted face as a joke, don’t be surprised if your loved one doesn’t want to eat it. Too, if you’re in a bad mood, but you’re trying to talk in a cheerful voice, your facial expressions will reflect how you’re really feeling. This, in turn, can affect your senior.
A person usually looks at someone or something they like, but looks away from something or someone that they don’t. Looking at someone conveys interest; looking away shows guilt or boredom.
The tone of voice which is used is often even more important than what is being said especially to an Alzheimer’s sufferer. So how you speak, the pitch of your voice, the pauses and the silences can reveal what the emotions are behind the words that you’re speaking. Now dementia patients respond well to friendly voice tones, and your loved one is no exception. So, by speaking in a friendly loving voice, the chances are that your loved one will perk up and smile. A calming voice should also be used on someone who is excited or upset. When this is done, then your senior may forget what he or she was upset about.
Mind your non-verbal expressions when communicating with the loved one suffering from dementia. You may notice then that you enjoy the company of your senior even more.
Non-verbal behaviors such as looks, head nods, hand gestures, body posture or facial expression provide a lot of information about interpersonal attitudes, behavioral intentions, and emotional experiences. Therefore they play an important role in the regulation of interaction between individuals. Non-verbal communication is effective in Alzheimer’s disease even in the late stages. Patients still produce non-verbal signals and are responsive to others. Nevertheless, few studies have been devoted to the social factors influencing the non-verbal exchange. Misidentification and misinterpretation of behaviors may have negative consequences for the patients. Thus, improving the comprehension of and the response to non-verbal behavior would increase first the quality of the interaction, then the physical and psychological well-being of patients and that of caregivers. The role of non-verbal behavior in social interactions should be approached from an integrative and functional point of view.
Changes in the ability to communicate can vary,
and are based on the person and where he or
she is in the disease process. Problems you can
expect to see throughout the progression of the
» Difficulty finding the right words.
» Using familiar words repeatedly.
» Describing familiar objects rather than
calling them by name.
» Easily losing a train of thought.
» Difficulty organizing words logically.
» Reverting to speaking a native language.
» Speaking less often.
» Relying on gestures more than speaking.
THE EARLY STAGE
In the early stage of Alzheimer’s disease,
sometimes referred to as mild Alzheimer’s in
a medical context, an individual is still able to
participate in meaningful conversation and
engage in social activities. However, he or
she may repeat stories, feel overwhelmed by
excessive stimulation or have difficulty finding
the right word.
Tips for successful communication:
» Don’t make assumptions about a person’s
ability to communicate because of an
Alzheimer’s diagnosis. The disease affects
each person differently.
» Don’t exclude the person with the disease
» Speak directly to the person if you want to
know how he or she is doing.
» Take time to listen to how the person is
feeling and what he or she is thinking or
» Give the person time to respond. Don’t
interrupt unless he or she asks for help
finding a word or finishing a sentence.
» Talk with the person about what he or she
is still comfortable doing and what they may
need help with.
» Explore which method of communication is
most comfortable for the person. This could
include face-to-face conversations, email or
» It’s OK to laugh. Sometimes humor lightens
the mood and makes communication easier.
» Be honest and frank about your feelings.
Don’t pull away; your friendship and support
are important to the person.
THE MIDDLE STAGE
The middle stage of Alzheimer’s, sometimes
referred to as moderate Alzheimer’s, is typically
the longest and can last for many years. As the
disease progresses, the person will have greater
difficulty communicating and require more
Tips for successful communication:
» Allow time for response so the person can think
about what he or she wants to say.
» Engage the person in one-on-one conversation
in a quiet space that has minimal distractions.
» Be patient and supportive. Offering reassurance
may encourage the person to explain his or her
» Maintain eye contact. It shows you care about
what he or she is saying.
» Avoid criticizing or correcting. Instead, listen
and try to find the meaning in what the person
says. Repeat what was said to clarify.
» Avoid arguing. If the person says something you
don’t agree with, let it be.
» Offer clear, step-by-step instructions for tasks.
Lengthy requests may be overwhelming.
» Speak slowly and clearly.
» Ask “yes” or “no” questions. For example,
“Would you like some coffee?” rather than
“What would you like to drink?”
» Ask one question at a time.
» Give visual cues. To help demonstrate the task,
point or touch the item you want the individual
to use. Or, begin the task for the person.
» Written notes can be helpful when a spoken
word seems confusing.
THE LATE STAGE
The late stage of Alzheimer’s disease, sometimes
referred to as severe Alzheimer’s, may last from
several weeks to several years. As the disease
advances, the person with Alzheimer’s may rely
on nonverbal communication, such as facial
expressions or vocal sounds. Around-the-clock
care is usually required in this stage.
Tips for successful communication:
» Treat the person with dignity and respect.
Avoid talking down to the person or as if he
or she isn’t there.
» Approach the person from the front and
» Encourage nonverbal communication. If you
don’t understand what is being said, ask the
person to point or gesture.
» Look for the feelings behind words or sounds.
Sometimes the emotions being expressed are
more important than what is being said.
» Use touch, sights, sounds, smells and tastes as
a form of communication with the person.
» It’s OK if you don’t know what to say; your
presence and friendship are most important.