Tips for communicating better with a patient with Alzheimer’s

Tips for communicating better with a patient with Alzheimer’s

If you want to understand what Alzheimer’s is and how it affects patients, you have to look carefully at how people suffering from this disease express themselves and communicate.

Why? Because one of the main symptoms of Alzheimer’s is the loss of communication skills.

In order to communicate with someone with Alzheimer’s, especially if they are in the more advanced stages of the disease, you need patience, empathy and excellent listening skills.

We know this is not always easy, but we are going to give you some useful strategies that will help both the patient and their carer understand each other and communicate better.

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Communication changes

Changes to communication skills vary depending on the patient’s specific characteristics or the stage of Alzheimer’s that they are in.

As the disease progresses over time, Alzheimer’s patients may show changes such as:

  • Difficulty finding the proper word
  • Using familiar words repeatedly
  • Resorting to describing objects instead of calling them by their name
  • Losing track of a conversation easily
  • Difficulty organizing words so that they make logical sense
  • Going back to speaking their native language (in patients that are abroad)
  • Tendency to talk less
  • Tendency to rely more on body language and gestures than verbal language.

Tips for better communication during the different stages of Alzheimer’s disease

Below is some advice for communicating with Alzheimer’s patients from the early stage, all the way to the late stage of the disease.

Communication in the early stage of Alzheimer’s

In the early stage of Alzheimer’s, also known as mild Alzheimer’s, the patient can still actively participate in conversations and social events and activities.

However, they may start repeating the same stories, feel overwhelmed when surrounded by other people or find it difficult to find the right words of things.

Here are some tips for communicating with a patient with mild Alzheimer’s:

  • Do not assume that the person lacks communication skills just because they have been diagnosed with Alzheimer’s. Remember that Alzheimer’s symptoms can present themselves differently depending on the person.
  • Include the person diagnosed with Alzheimer’s in conversations.
  • Ask the person what they would like to do, who they feel comfortable with or what they need help with.
  • Ask them how they would like to talk, either face to face, over the phone or virtually via video chat.
  • Speak directly to the person, they will understand you. Do not expect the carer to respond for them.
  • Take your time when listening to the person. Let them express their thoughts, feelings and needs.
  • Allow sufficient time for conversation. Often they may need to speak at a slower pace, so adapt the pace of the conversation to give time to respond.
  • If you find something funny, it’s OK to smile. Humor is a relief and makes the conversation more relaxed.
  • Keep in contact with them, you may not realize it, but your friendship, honesty and support are very important to them.

Communication in the intermediate stages of Alzheimer’s

The intermediate stage of Alzheimer’s, also known as moderate Alzheimer’s, is usually longer and can last for several years. As the disease progresses, the patient finds it increasingly difficult to communicate and requires more hands-on care.

Here are some tips for communicating with a patient with moderate Alzheimer’s:

  • Engage in conversations with the person in quiet spaces, without a lot of background noise or distractions.
  • Try to speak slowly and as clearly as possible.
  • Keep eye contact while talking to them. This shows that you are actually interested in what they are saying.
  • Only ask one question at a time.
  • Try to ask questions that are easy to answer, like yes or no questions. For example, instead of asking “Do you want something to drink?”, ask them “Do you want tea or coffee?”.
  • Avoid criticizing or correcting what the person is saying. Instead, listen calmly and try to figure out the meaning of what they are trying to say (as you would do with a child).
  • Avoid arguing. If the person says something you do not agree with, avoid contradicting them.
  • Give the person enough time to be able to think about their response.
  • Be patient and slow down. Remember that they are the ones who need your support and understanding the most.
  • If you think that the patient is starting to get worried, show them that you are there to  offer them a sense of calm and that they can trust you.
  • If they are confused by what you are saying, you can try writing notes.
  • Give clear, step-by-step instructions for carrying out day-to-day tasks.
  • Help them with visual cues. Demonstrate what you want the person to do using gestures.

Communication in the final stage of Alzheimer’s

The final stage of Alzheimer’s, also known as severe Alzheimer’s, can last anywhere between a few weeks, to many years. As the disease develops, the patient will start to depend more on non-verbal communication (like facial expressions or sounds). Usually, patients in this stage require constant care.

Here are some tips for communicating with a patient with severe Alzheimer’s:

  • Move in front of them and say who you are.
  • Pay attention to their feelings, not just their words or sounds. Usually the emotions they express are more important than words alone.
  • Support and encourage non-verbal communication. If you do not understand what they are trying to say, ask them to act out what they mean. Remember that communication is not just verbal, make use of body language.
  • Use the other senses as a form of communication: touch, sounds, smells and tastes can be important for communicating with a person with Alzheimer’s. For example, they may associate the smell of a certain soap they use with bathing. You could use this smell to communicate that it is time for them to take a bath.
  • Treat the person with dignity and respect. Avoid being condescending or speaking as if the person does not exist or is not there. Although they have difficulty expressing themselves, they can still hear and feel.
  • It’s OK if you do not know what to say. What really matters is your presence, support, care and friendship.

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If, as a carer, you often feel frustrated that you cannot communicate with a person with Alzheimer’s, this is totally normal, and we are here to help. Why not share your experiences, tips or questions with us?