My mom was diagnosed with dementia. After falling and hitting her head a few times the dementia escalated. Caring for her in the mild stage was doable. As she progressed and needed 24/7 care I was forced to put her in a skilled nursing facility. Immediately after the move she forgot my name. After she grew accustomed to her new environment she began to remember my name again. On average I visit my mom every 2 days which I think helps her to remember me. Most of the time she will use my name during our visit. She does not remember her other 3 children in part because she rarely sees them.
Here are 10 important things I have learned when communicating with my mom:
#1 Set a positive mood for interaction. Attitude and body language communicates feelings and thoughts more strongly than words do. Speak to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice, and physical touch to help convey your message and feelings of affection.
My mom loves for me to softly hold her hand. If I let go she will reach for my hand. When I am leaving she sometimes will reach for me and will ask me to stay longer or spend the night.
#2 Limit distractions and noise. Go to a quiet place if possible, turn off TV, radio, shut the door, get away from other people. Before speaking, make sure you have her attention, address by name, identify yourself by name and relation, and use nonverbal cues and touch to help her keep focus. If she is seated get down to her level and maintain eye contact.
Yesterday was a beautiful day when i visited my mom. I rolled her out to a quiet and peaceful courtyard. She loved it. When the weather is not as nice I might taker her to one of the lovely visiting areas at her facility.
#3 State your message clearly. Use simple words and sentences. Speak slowly, distinctly, and in a reassuring tone. Refrain from raising your voice higher or louder. If she doesn’t understand the first time, use the same wording or repeat your message or question. If she doesn’t understand, wait a few moments and rephrase. Use names of people and places instead of pronouns (he, she, they) or abbreviations.
#4 Ask simple, answerable questions. Ask one question at a time, those with a yes or no answer work best. Refrain from asking open-ended questions or giving too many choices. For example, Would you like to wear this pink or red lipstick today? Allowing her to see the choices, a visual response or cue will help clarify your question and guide her response.
#5 Listen with your ears, eyes and heart. Be patient in waiting for your loved one’s reply. If she is struggling with an answer, it’s okay to suggest words. Watch for non-verbal cues and body language. Always strive to listen to the meaning and feelings that underline the words.
#6 When the going gets tough, distract and redirect. Mom enjoys looking at her photo album. We do this often. If she can’t remember someone on a page I might say their name or I might just turn the page. This activity is good when preparing her for a visit by someone. If one of my children is planning on visiting her I will show her many photos of them and repeat their name. Often when one of them walks in the door she will greet them by name. This is from me preparing her.
A couple of weeks ago when she saw a photo of her son and I repeated his name in several photos and she responded How is Chuck? I answered her and told her he loved and missed her. She smiled and said that’s nice.
#7 Respond with affection and reassurance. People with dementia often feel confused, anxious and unsure of themselves. Further, they often get reality confused and may recall things that never occurred. Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real) and respond with verbal and physical expressions of comfort, support and reassurance. Sometimes holding hands, touching, hugging, and praise will get the person to respond when all else fails.
#8 Remember the good ole days. Remembering the past is often a soothing and affirming activity. Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier. Therefore, avoid asking questions that rely on short term memory, such as what they had for lunch. Instead try asking general questions about the person’s past, this info is likely to be retained.
Yesterday I sang every hymn I could remember. My mom got tears in her eyes. When I played the music from my iPhone my mom began to hum along as I sang. We did this for 3o minutes. It was a beautiful visit. After I turned the music off she squeezed my hand 3 times which is how she communicates “I Love You.”
#9 Maintain your sense of humor. Use humor whenever possible, though not at their expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.
My mom loves to laugh. When we do this and I leave she often says “We had a fun time didn’t we?”
#10 Give them time. If my mom is tired or just woke from a nap it may take time for her to come around if at all. I have learned the best time in the day to visit her. Often it is after 30 minutes that my mom will begin to communicate the most. During the first half hour I still sit with her and communicate but she needs time to come around.
My mom has dementia but she is happy. She doesn’t worry like she once did before dementia. She laughs. She enjoys meal time, especially dessert. She hugs. She likes pretty clothes and jewelry. She says I love you often. I know the day will come when she will not speak at all. But I can still communicate love to her.