How to deal with people that suffer from dementia
What is dementia?
Dementia is the overall name for multiple disorders within your brain. Also Alzheimers and Parkinson belong in the dementia category. However, the severity of dementia comes in different stages. A light form of dementia would be that you would forget certain things that happened recently (short-term memory loss) and the stronger form would be where you for example forget or not understand all about your surroundings which causes aggression and anger. Many people with dementia cannot communicate and understand communication (conversations) in the same way that we would. A different type of communication would then be needed.
Types of Dementia
There are three types of dementia, which can be recognised:
- Aphasia: With this type of dementia a person would most of all have problems speaking and understanding language, they will not be able to pronounce words correctly, nor understand certain words or word groups.
- Agnosia: Objects are nog longer recognised when seen/felt, and the knowlegde about using them will also be lost. This is particularly dangerous when using certain sharp objects or forgetting to turn of certain objects after use.
- Apraxia: A person will not be able to perform certain actions in the correct sequence nor do it automatically. For example, not taking clothes off before showering, or getting dressed and then taking a shower. When getting dressed it is important that you help them to place their clothes or certain objects in the correct sequence instead of leaving things in a pile. They will need more direction.
How the brain "works"
Symptoms of dementia
Dementia knows different types but even more different symptoms, ranging from light until dangerous. Most of the symptoms are disorders in the cognitive functions, and these functions a person needs to deal with themselves and the surrounding environment/reality. Without a good memory one cannot orient themselves in the world.
Short-term memory loss
Your short-term memory ensures that you remember things that have happened recently or in the past few days. You automatically remember things that were important or interesting for your. When you suffer from dementia, you will not automatically remember these things anymore. You may not remember what you did yesterday or even an hour ago. Forgetting someones name might happen but it gets more dangerous when they forget they were cooking something and leave pots and pans burning on the stoves with the gas on!
Long-term memory loss
Your long-term memory makes you remember things that happened a long time ago, going back years. People with dementia in a later stage will often go back to their childhood, forgetting what happened in the years after that. They will often tell you about their childhood as if they are still a child (forgetting that they are actually not a child anymore) or get confused what happened and what did not happen. They want to go to their job while they retired years ago, or want to bring their children to school.
Loss of judgement and dealing with critique
It can also happen that dementia will lead to lack of judgement of what is accepted within our society. People then do not know anymore how to behave properly. Examples are dressing inappropriately or being naked (in public). They can also start to yell or scream or curse in public because they do not know that this is unacceptable within their environment. It is also difficult for people with dementia to deal with criticism because they cannot process it well in their brain and therefore feel it as an attack on their person. This can cause many conflicts as their behavior will not be “accepted” within society. This behavior will lead to negative reactions from their surroundings and that will then again lead to anger or aggression.
Dementia can also cause people to lose awareness of time, location and place. With this type of dementia it is important to go along with the person that suffers from dementia. If the person wants to peel potatoes for dinner at 9 am in the morning, let them do this instead of telling them that it is not dinner time. This will just anger or confuse them more. Keep them in the routine that they (think they) have.
How to communicate?
Now you know the types and symptoms of dementia, you can imagine what such a person goes through in their daily life and how they see things. Realize that someone who suffers from dementia have (partially) lost their grip on life in a mental or physical way and they suffer from it daily. There are a number of tips that will help you to better communicate with them.
Make eye-contact when speaking and say their name. This way you make sure that the person focuses on you and they will sooner understand what you say and mean.
Speak slow and pronunciate well
people with dementia have a slower working mindset. If you speak to slow, then they will not keep up with you. It is already difficult enough for them to understand you when you speak slow and clear. Adapt your tempo to the other person, but don’t exaggerate.
Use short sentences
If you use sentences of more than 4 or 5 words, then the chances are big that the person with dementia will already have forgotten the first word after you pronounced the last word. If you use short sentences it will increase the chances of them understand you.
If you feel that a certain word or group of words is not well understood, try to use alternative (easier to understand) words or word groups. An example: instead of “would you like some coffee”, ask “what would you like to drink?”
You can strengthen your words by using gestures when possible. Often it works better to bend slightly and giving someone your hand than to ask: ”please come with me”. Both would be even better.
People with dementia can easily panic when they do not understand something or when they feel misunderstood. Speaking with a calm voice sooths them and will keep them at peace.
Take your time
Rushing things will confuse or cause panic to people with dementia. They will then resist or become angry or even aggressive. This is not something you want, so take your time and prepare them that something will happen or has to be done. You also do this with children, when you tell them 5 or 10 minutes before bedtime that they should prepare for bed. Give them time to prepare for something mentally and physically.
Do not use force
Do not use force on someone with dementia, do not make them do something because you want it. Again this might cause fear and aggression. If he/she does not want to do something, don’t! You can try it again a bit later instead. Perhaps then you will be more lucky. Also ask yourself if something really needs to be done.
Having to choose means that you are capable to consider multiple issues to finally be left with the choice you want. Dementia will make you less (or not) capable to make considerations and therefore having to make a choice can confuse you or make you angry or scared. Try to always avoid giving multiple options, but rather give just one.