Communication strategies

Memory and intellect deteriorate as dementia progresses, yet people with dementia continue to interact. How staff respond can have profound effects on a person’s wellbeing.

Barriers

Barriers to communication may relate to individual issues or to social and physical environments. Personal barriers may include:

• health status
• physical ability
• cognitive and sensory ability
• emotional wellbeing
• personality and mood
• culture and knowledge of English.
• A facility’s institutional values and philosophy affect the social environment through policies on:
• staff recruitment and training
• staff-to-staff communication
• routines
• rosters
• staff–resident ratios
• staff encouragement and support.

In the physical environment, communication is affected by:

• building design and layout
• size of rooms
• size and placement of furniture
• width and length of corridors
• extent of private space
• lighting
• ambient noise.

Principles

Change: As dementia progresses adjust how you communicate to suit a person’s changing needs.

Context: Guide a person through any task, activity or request by explaining or describing what is happening or about to happen.

No expectations: Make it clear verbally and non-verbally that a person may respond or not as they wish; that nothing is required of them.

Reassurance: Communicate verbally and non-verbally to reassure a person they are accepted.

Consistency: Verbal responses and non-verbal communication should not contradict each other.

Strategies

• Talk to a person, rather than about them to others.
• Address a person by their preferred name, not ‘dear’ or ‘love’.
• Tell a person what you are doing or going to do.
• Focus your full attention on the person and make eye contact.
• Use words and sounds of encouragement.
• Do not use a demeaning or condescending tone of voice or hostile gestures or stance.
• Do not invade a person’s personal space.
• Speak at a slower pace.
• Pause between one topic and the next.
• Use prompts such as pictures, photographs and simple signs.
• Accept a person’s feelings.
• Use non-threatening physical contact.
• Do not make abrupt changes to routines.
• Get to know a person’s life story so you have a store of background information for questions and conversations.
• Use individualised memory books to improve and keep communication skills.
• Use written and pictorial signs in significant places around the facility.
• Place memory charts containing photographs, brief statements about the person and conversation topics on bedroom walls and other appropriate places to aid communication.
• Use other techniques and therapies that help communication like aromatherapy, attention focusing, bright light therapy, massage, music therapy, pet therapy, reminiscence sessions and walking.