Keep Tone, Clarity and Goals in Mind

Because of the cognitive changes with Alzheimer’s and other dementias, communication is often challenging.  Dementia is a broad term that refers to a decline in mental ability significant enough to interfere with daily life.  Of all the dementias, Alzheimer’s disease is the most common (60 – 80% of all cases), and of the estimated 5 million Americans with Alzheimer’s disease, the majority are age 65 or over.

Herewith some tips caregivers can use to help communication go a little smoother.  These tips were recently presented by the Gerontological Society of America, in their publication “Communicating with Older Adults” (2012).

·         Maintain a positive communicative tone when speaking with an older adult with dementia.  Older adults with dementia remain able to understand the tone of communication.  Thus, a soft tone with a patient manner can be helpful in reducing problem behaviors like agitation.

·         Avoid speaking slowly to older adults with dementia.  Speaking slowly with older adults with dementia only makes it more difficult for them to remember all the words said before they can comprehend the whole sentence.  Instead, maintain your regular rate of speech, and focus on intonation and enunciation.

·         Pose different types of questions according to your conversational goals.  Depending on your goal – gathering information or encouraging conversation, do the following:

For gathering information, use closed-ended or yes/no questions such as “Would you like iced tea or water?” or “Are you tired?”

For encouraging conversation, use open-ended questions such as “What show would you like to watch?

·        Simplify sentences by using “right-branching” sentences.  What does this mean?  In right branching statements, the main clause is followed by the subordinate clause.  For example, “Get in the car and we will go to the store.”  This is the preferred and simpler statement vs. “If you want to go to the store, get in the car” (a left branching statement).  The left branching sentence requires the listener hold the information of the first clause (subordinate) in order to understand the full sentence.  This places a strain on the individual’s working memory.

·        Use verbatim repetition or paraphrase sentences to facilitate comprehension.  This step is often what we do naturally when we know the individual with whom we are speaking does not comprehend what we are saying.  By repeating, we reinforce what was said, aiding in the memory trace of the original message.  When we paraphrase, we revise our original sentence by removing the confusing word or words and substituting them with more understandable words.  An example of paraphrasing would be changing a sentence from “Tomorrow, when I return from the airport, I will go grocery shopping,” to “Tomorrow I will go grocery shopping