12 tips that improve communication

According to the 2010 NHPCO Hospice Facts and Figures: Hospice Care in America, dementia represents the third most frequently cited non-cancer primary diagnosis for hospice. As this percentage (11.2% of all hospice patients) continues to grow, the importance of educating hospice staff members and volunteers about effective strategies for communication with dementia patients also increases.

1. Be calm, patient and supportive

• Let the person know you're listening and trying to understand what is being said.

• Keep good eye contact. Show the person that you care about what is being said.

• If he or she is having trouble communicating, let the person know that it's OK. Encourage the person to continue to explain his or her thoughts. Give the person time to think about and describe whatever he or she wants. Be careful not to interrupt.

2. Avoid criticizing or correcting

• Don't tell the person that what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said, if it helps to clarify the thought.

• Don't argue if the person says something with which you don't agree. Arguing usually only makes things worse.

• Offer a guess if the person uses the wrong word or cannot find a word. If you understand what the person means, you may not need to give the correct word. Be careful not to cause unnecessary frustration.

3. Focus on the feelings, not the facts

Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.

4. Address the person by his or her name

This is not only courteous, it helps orient the person and gets his or her attention.

5. Speak slowly, and use short, simple words and sentences

Don't overwhelm the person with lengthy requests or stories. Speak in a concise manner. Keep to the point. In some cases, slang words may be helpful. Talk slowly and clearly.

6. Ask one question at a time

Break down tasks and instructions into clear, simple steps. Give one step at a time or ask one question at a time. Don't overwhelm or confuse the person with too many questions at once.

7. Avoid vague words and negative statements

If you ask the person to "Hop in!" — he or she may take that as literal instructions. Describe the action directly to prevent confusion, "Please come here. Your shower is ready" or instead of saying "Here it is!" say, "Here is your hat."

Turn negatives into positives by saying "Let's go here" rather than "Don't go there."

8. Turn questions into answers

Try providing the solution rather than the question. For example, say "The bathroom is right here," instead of asking, "Do you need to use the bathroom?"

9. Give visual cues

Demonstrate your request by drawing, pointing at, or touching things. You can also start the task for the person. Try using simple written notes for reminders, if the person is able to understand them. A written response may also help when a spoken one seems too confusing

10. Treat the person with dignity and respect

Avoid talking down to the person or talking as if he or she isn't there.

11. Avoid quizzing

Although reminiscing may be healthy at times, avoid causing anxiety for a person who may not remember. Instead of asking "Do you remember when ... ?" make a statement such as "I remember when ... ."

Never greet someone with "You remember me, don't you?" Instead, introduce yourself and let the person know that you've met before, such as, "My name is Mary and last week you and I had a wonderful time talking about your photographs."

12. Be patient, flexible, and understanding

The person may need extra time to process your request. Give the person the time and encouragement he or she needs to respond. If the person doesn't respond, wait a moment. Then ask again. Ask the question in the same way, using the same words as before.

Excerpted from: Communication. Best Ways to Interact with the Person with Dementia. Chicago, IL: Alzheimer's Association; 2010.