Dementia Communications: Tips for Nursing Home Caregivers
Tackling the tough task? Communicating with nursing home residents who have dementia can tax your caregiving team. And lack of training can lead to unexpected behavioral problems. Understanding some basic ideas can help your staff improve their effectiveness. Try out these tips.
Understand your resident.
Understanding each resident’s unique experience with dementia can position you for successful communication. Some hallmarks of dementia may include having trouble finding the right word, losing a train of thought, repeating things, or becoming less verbal. Each person’s skills and stressors vary.
Skills change over time, too, as dementia progresses. Take the time to understand your resident and to notice what communications skills are within and beyond a person’s control. Be open, observant, and patient in learning what works best. Be respectful (not patronizing) of each person’s experience.
Manage your body language.
Experts suggest that up to 90% of communication with a dementia patient is nonverbal, and this is human nature for all of us. To be sure you’re relating an open, positive message, try these ideas:
- Approach your patient so they can see you (not from behind).
- Maintain good eye contact.
- Position your face at the same level as the patient’s face.
- Relax your facial muscles.
- Avoid sudden movements.
- Manage your voice and the emotion you convey. Your calm and warmth can evoke the same in others.
- If comfortable, touch a patient’s arm or hold a hand.
Questions can generate tension for an individual with dementia. Special techniques can make things easier:
- Ask one question at a time and allow plenty of time for a person to respond.
- Give simple choices (not a list). Work from your knowledge of a patient’s preferences whenever possible.
- When helpful, ask a yes-or-no question rather than pressuring a patient to recall a word or articulate an idea.
- If a patient has trouble articulating, offer the option to point to what they want. Pictures and pointing can help empower a patient to express his or her wishes.
- Avoid questions that begin with, “Do you remember…?”
- Avoid correcting or arguing with what someone says.
- Listen not only to words, but to body language and the feelings expressed.
Give instructions with care.
- Ensure the environment is free of excess noise or commotion.
- Speak slowly and clearly.
- Go step by step; keep it simple.
- Offer visual cues to help convey the instruction.
- Give reassurance and positive reinforcement.
- Honor a patient’s preferences and avoid talking down to her or him.
- Avoid pushing for action; offer a break when needed.
Understand how much feelings count.
Research from the University of Iowa confirmed that a patient with Alzheimer’s who may not remember everything that happened recently will nevertheless remember feelings. Feelings count, and caregivers have a huge influence on the lasting emotional experience of nursing home residents. “Patients may not remember a recent visit by a loved one or having been neglected by staff at a nursing home, but those actions can have a lasting impact on how they feel,” said the researchers. They said that their work “highlights the need for caregivers to avoid causing negative feelings and to try to induce positive feelings.”
Get the support you need.
A team approach built on person-centered care invites residents to be themselves in a safe and caring environment. It confers dignity and can help ease the suffering of dementia. There will always be challenging situations. It’s helpful to draw on the support of clinical psychologists and nurse practitioners who specialize in geriatric care. If you’re facing communication or behavioral challenges, why not reach out to the clinical team at GuideStar Eldercare? Our on-call team serves commnursing homes 24/7. We’re here for you!