Communication and "The Empty Shell"

Sadly, dementia does indeed transform people into shadows of their former selves, but those living with dementia are far from “empty shells.” Yes, the shell may become more and more difficult to open. Some days it might not open at all. But never forget that there is a beautiful, unvarnished pearl within.

Understanding how to “open the shell” gives us opportunities to meaningfully connect with our dementia-afflicted loved one — even if only for a fleeting moment. Just as the right tools and a lot of technique is required to shuck an oyster, there is technique and artistry involved with communicating or connecting emotionally with a loved one who has dementia.

Here are 10 tips on how to effectively communicate with someone who has moderate to severe dementia.

1.    Recognize what you’re up against. Dementia inevitably gets worse with time. People with dementia will gradually have a more difficult time understanding others, as well as communicating in general.

2.    Avoid distractions. Try to find a place and time to talk when there aren’t a lot of distractions present. This allows your loved one to focus all their mental energy on the conversation.

3.    Speak clearly and naturally in a warm and calm voice. Refrain from ‘babytalk’ or any other kind of condescension.

4.    Refer to people by their names. Avoid pronouns like “he,” “she,” and “they” during conversation. Names are also important when greeting a loved one with dementia. For example: “Hi, Grandma.  It’s me, Jeff,” is to be preferred over, “Hi. It’s me.”

5.    Talk about one thing at a time. Someone with dementia may not be able to engage in the mental juggling involved in maintaining a conversation with multiple threads.

6.    Use nonverbal cues. For example, maintain eye contact and smile. This helps put your loved one at ease and will facilitate understanding. And when dementia is very advanced, nonverbal communication may be the only option available.

7.    Listen actively. If you don’t understand something your loved one is telling you, politely let them know.

8.    Don’t quibble. Your conversations are not likely to go very far if you try to correct every inaccurate statement your loved one makes. It’s okay to let delusions and misstatements go.

9.    Have patience. Give your loved one extra time to process what you say. If you ask a question, give a moment to respond. Don’t let frustration get the better of you.

10.  Understand there will be good days and bad days. While the general trend of dementia sufferers is a downward decline, people with dementia will have ups and downs just like anyone else.

Do you have advice for us about communicating with someone who has Alzheimer’s or dementia? In what ways have you been able to connect with your loved one despite the obstacles? Share your suggestions with us in the comments below.