Dementia is common in older people and has different phases. Sometimes it means that their short-term memory has gaps, but it can also happen that they are less able or unable to assess something or can handle criticism. This means that you have to adjust your communication slightly with people with dementia in order to be able to deal with them well.
Symptoms of dementia
Dementia symptoms are characterized by disturbances in cognitive functions. These functions are functions that a person needs to deal with themselves and the reality surrounding them. Without a good memory you cannot properly orient yourself in the surrounding world. There are different types of dementia that are characterized by the following symptoms.
Loss of short-term memory
Your short-term memory ensures that you remember the things that just happened or during the day. Most people automatically remember the things they consider important and not the rest. But when someone has dementia, this no longer works and they remember fewer and fewer things. This can be quite innocent, such as forgetting a name or that you did some shopping that day. But you still have to be careful because it can also happen that someone leaves the boiler on the gas or even forgets to turn off the gas.
Loss of long-term memory
Long-term memory is the things that you have experienced over the years and that you have remembered. In dementia, long-term memory usually remains intact for a long time, but over time gaps will also appear here. When people are in this process, they recount things from their childhood as if they had just happened and events are also confused. Examples are that they think their children are still young and going to school or that they want to work where they have not been for years.
Loss of judgment and dealing with criticism
It may also be that a person with dementia can no longer properly assess what is and is not acceptable from a social perspective. An example of the type of behavior they exhibit is that they dress immodestly or even walk around naked, sometimes swearing or shouting. People with dementia also find it more difficult to deal with criticism because they cannot process it properly in their heads and tend to see criticism as an attack on themselves. This type of behavior will often give rise to conflicts, because the behavior is not tolerated (in society). This behavior leads to disapproving reactions from the immediate environment. These disapprovals in turn lead to anger or even aggression in a person with dementia.
Disorientation
People with dementia can also be disoriented and therefore no longer realize the times, where they are or who they are with. With this type of dementia it is important to go along with the way of thinking of the person with dementia. For example, if someone wants to peel potatoes at 10 a.m. because he/she thinks it’s already time for dinner, let that person do it instead of explaining that it’s not time yet. If you do this, there is a risk that the person with dementia may become aggressive or panic because you are taking them out of the routine they (think they) have at that moment.
Loss of initiative
It may also be that a person with dementia no longer takes or does not want to take initiative. In this case, by taking initiative we mainly mean actively doing something. For example, deciding to prepare food, get up, or go for a walk. These are all types of initiatives that the person with dementia will not take. You often have to help these people get started a little more, and they must also be positively stimulated. Remember that it is encouraging and not forcing, this is actually counterproductive.
Forms of dementia
In addition to the many symptoms that dementia can cause, there are different types of dementia. These three forms are:
- Aphasia: With this type, people mainly have problems with speech and language comprehension, they can no longer pronounce words properly and no longer understand certain words or word groups.
- Agnosia: With agnosia, objects are no longer recognized by touch, the knowledge about their use has disappeared. This can be dangerous if the person with dementia wants to use certain objects, but cannot handle them.
- Apraxia: the person with dementia can no longer perform all kinds of actions automatically or does not do this in the correct order. Consider first getting dressed and then showering or first wearing pants and a sweater and then underwear. You can help a person with dementia by arranging clothes/things in a good order instead of putting everything in a pile.
How do you communicate with people who have dementia?
Now that you know what the symptoms and forms of dementia are, you can also imagine what daily life is like. Realize that a person with dementia has lost most of their grip on daily life, either mentally or physically, and they suffer from this on a daily basis. There are a number of tips that can help you communicate better with someone who has dementia.
- Make eye contact: Making eye contact and addressing the person by name ensures that someone focuses on you, making them more likely to understand what you are telling them or asking them.
- Speak slowly and clearly: people with dementia often have a slow train of thought. If you talk too fast, they won’t keep up with you. It is difficult enough for them to understand clearly understandable words, let alone if it is unclear. Adjust the speed and clarity to the other person’s pace, but don’t overdo it.
- Use short sentences: If you make a long sentence of more than 5 words, there is a good chance that a person with dementia will not understand it. It turns out that after 4 or 5 words, the first word is already forgotten.
- Use alternatives: if it turns out that a certain word is not understood, it does not always have to do with understanding but with understanding. There is little point in repeating something. Instead, try to use other (if possible easier) words/phrases. E.g. if “would you like coffee” is not understood, replace it with “what would you like to drink”
- Use gestures: When words fail, use gestures. A combination is even better. Bending slightly forward and extending your hand invitingly often works better to get a person with dementia to stand up than asking: “Are you coming with me?”
- Reassuring talk: People with dementia are often (a little) confused and can quickly panic if they do not understand something or feel that they are not understood. So always speak reassuringly and clearly.
- Take your time: doing something quickly creates resistance in a person with dementia. Better not do this! Give the person with dementia time to adjust to the fact that something is going to happen. For example, indicate a while in advance when it is time for dinner or when they are going outside to run an errand. This way they can prepare themselves mentally and physically.
- Don’t force: coercion causes fear and sometimes aggression. If a person with dementia does not want something then it stops, try again later. Always ask yourself whether something is really necessary or whether only you think so.
- Respond to feelings: people with dementia often find it difficult to explain what is bothering them. It is clear that something is bothering her. By responding to this you will achieve more than by trying to find out what is going on. The person with dementia then feels understood sooner and can relax more quickly.
- Try to avoid choices: choosing means being able to weigh several things and ultimately arrive at one. This requires abstract thinking, something that people with dementia quickly become unable to do. For example, don’t ask “do you want to eat or do you want to go to the toilet first”, but rather “do you want to go to the toilet”? If the answer is “no”, then you ask “would you like to eat now”?
- Do not ask for understanding for your position: you can point this out to a person with dementia who, in your opinion, is unfairly angry with you, but do not ask the question: “Can you imagine that I don’t like this”? They can’t do this! If you want to indicate that you don’t like something, say “I don’t like this”!
