Why do some people with dementia stop talking?

Dealing with people with dementia - 13 tips

Further information

Learning to understand people with dementia

That sounds like a difficult task, of course - it is. However, it helps if you keep the following points in mind:

1. A person with dementia is still an adult

Despite their illness, a person with dementia is still an adult. Therefore, you shouldn't denounce him or, what's worse, make him down to business, for example by pushing him around without comment or by not talking to him at all. Nor should you patronize him. Meet him at eye level with real empathy.

2. The world of someone with dementia makes sense

This is a basic attitude to keep in mind: In the world of someone with dementia, their actions and thoughts make sense. Often people with dementia can no longer distinguish the present from the past. Try to put yourself in the shoes of the person opposite you; that gives this world a justification. As a result, you approach these people with a completely different attitude than if you simply label them as "demented" and measure them according to our normal point of view.

Use the right communication

Communication is increasingly difficult for people with dementia. Cognitive skills are becoming less and less and with age, hearing and eyesight also decrease in many people. In addition, many people with dementia are frustrated, anxious, or feel increasingly helpless as a result of the changes they have observed themselves, especially in the early stages of the disease. That also makes communication more difficult. Therefore, one should stick to the following tips:

3. Use simple and clear language

Complex sentences and metaphors, irony and sarcasm are not understood by people with dementia. Therefore, one should use sentences with a single message that are as straightforward as possible. Important information should be repeated often - the same wording should always be used, this is more memorable than variations. Clear and slow pronunciation is also part of clear language.

4. Ask correctly

Questions pose a challenge to people with dementia. You have to decide, you have to remember, you have to explain yourself. However, a large part of the difficulties can be relieved of them by asking the right questions:

Yes-no questions and questions with few alternatives

With these types of questions, people with dementia are given a very simple choice, which is why they should definitely be preferred to so-called W-questions (how, who, what, why ...).

Example: "Are you okay?" instead of "How are you?"

The W questions open up a very broad horizon of possible answers, so they should be avoided. Even with alternatives, you should keep yourself to a minimum.

Example "Do you want apple juice or orange juice?" instead of "Which juice would you like to drink?"

Leave time for an answer

It is difficult for people with dementia to answer. Due to the increasing loss of language, they have to search for the right words and then give them meaning again, which is why they need a lot of time to do so. They should be given this time. Otherwise you put them in stressful situations or you run the risk of patronizing them again.

5. Communicate positively

Criticism, corrections, discussions or accusations usually do not have a positive effect on people with dementia. On the contrary, it often embarrasses and frustrates them. Therefore, one should refrain from doing so. However, praise creates a good mood - it is no different for people without dementia.
Allegations on the part of the dementia changed should be treated positively. The accusation that something was hidden or that someone was stolen, for example, can be better countered by taking away the fear and looking for the object together instead of fending off.

Fears and frustrations should be addressed depending on the situation and context and taken seriously. "What can be behind the fear?" "What does my counterpart need in this situation?" are helpful questions that family members can ask themselves.

6. Communicate non-verbally as well

In addition to linguistic communication, clear body language should always be used. Supportive and concise facial expressions and gestures help to make your own message clearer and facilitate understanding.

You can also participate in things by supporting the movements of the person with dementia, or you can show them so that they can be imitated. It is also important to keep eye contact - eye contact also expresses the appreciation and respect that is shown to people with dementia. It provides stability and security and is often the only way to establish a relationship at the end of the illness.

Challenge and support - if appropriate!

Those who are active can better remember what they have learned and maintain their independence. That is why people with dementia should be challenged and encouraged constructively. Of course, this should be adapted to the physical and mental abilities, excessive demands should always be avoided. Helpful questions to ask yourself are: What else can they do well? What makes you happy? Where does the feeling of competence still exist?

7. Exercise the body

Occupational therapy and physical therapy are great ways to maintain mobility. Walks in the fresh air are said to delay the progression of the disease, according to a recent study.

8. Awaken memories

By stimulating the five senses one can evoke memories that improve the quality of life. An example of a professional approach to this subject is music geragogy.

In our conversation with music geragogue Marie Rohde you can gain deeper insights into this topic.

Through music, a bridge is built into the past of people with dementia, which can no longer be rationally established. "Listening, singing or dancing brings back memories: Who am I, what can I do, what did I appreciate, what gave me pleasure?" You can answer these questions through music - if you choose the right music that had a meaning in the life of people with dementia.

9. Maintain independence

Regular repetition of known activities can keep them longer. Even learning something new, not too complex, is possible to a limited extent and, provided that it is constantly repeated, can be accessed over a longer period of time. That is why people with dementia should do everything they can do themselves or whatever they need to do with a little help.

10. Promote social contacts

Meeting friends who you knew before the diagnosis of dementia also has a positive effect on the mood of people with dementia and thus also on the course of the disease. Regular social contacts and activities such as small excursions or other joint leisure activities promote a social environment that keeps people active for longer. This also trains independence and means that what you have learned is retained for longer.

11. Create structure and routine

Unforeseen events, surprises and changes in habits require intellectual engagement that is increasingly difficult for people with dementia. Therefore, make sure to create a structured everyday life with a clear routine for the person concerned, as far as that is in your power. This concerns, for example, the time of meals, bedtime or hygienic processes.

12. Housing adaptation

In addition to basic, mobility-friendly accessibility, there are some adjustments that make the life of people with dementia in their own four walls more pleasant and easier.

In our article on barrier-free living you can find out what you have to consider when it comes to barrier-free living.

The clarity of the premises is also important. Too many impressions can easily confuse and overwhelm people with dementia. The facility should therefore be reduced to a minimum that meets the comfort and requirements.

Doors should be left open as much as possible or hung completely to make it easier for the person concerned to find their way around. Individual rooms can be marked accordingly with small pictures; for example the bathroom, the kitchen or the bedroom. Pictures or pictograms are better suited than labels because they can be identified more easily.

In addition to the spatial orientation, the temporal orientation is also of great importance. You can support this by, for example, attaching clearly visible calendars with large letters in living rooms.

13. Avoid excessive demands on your own

As in any situation in life, it is also important when dealing with people with dementia that you do not overdo yourself too much. It doesn't help anyone if you completely sacrifice yourself. You don't just neglect your own interests and needs. This failure also builds up a certain frustration, which is then often left out on the person concerned - both verbally and physically.

It is therefore advisable to take time out from caregiving whenever possible. For example, you can get support from a nursing service. You can also ask other relatives and / or partners to take over the care at a certain time so that you can pursue your hobbies or just relax. So you can look after your relatives with dementia, fresh and relaxed.

About Marie Rohde: The music geragogue and studied musicologist creates tailor-made musical offers for and with residents of shared apartments for people with dementia and in day care facilities. She is happy to be able to contribute to a better quality of life and well-being in everyday life. In coaching in the Jedermann Group, she gives employees impulses for a helpful, stress-free and relaxed approach to dealing with people with dementia, leads case discussions and gives training on the topic of dementia changes.

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