How do you communicate well with a person living with dementia?

A common theme among the many questions we have been asked revolves around how to best communicate with someone living with a form of dementia. The keys to establishing good and meaningful communication with people living with dementia revolve around several important ideas:  

• The first is to talk to the person directly, not their carer. Their carer or family member may be present and help contribute to the conversation, but make sure you direct questions to the person first. Wait for their response and be mindful that it may not be a verbal response. Watch for their facial expressions and body language. For example, a smile or frown can help guide your response to their answers. If more is required, then look to a family member or carer for more information, but bear in mind they are sharing their views and observations only.
• It is very important to understand that good communication involves far more than just the words you use. Some research suggests that less than 10% of communication is the spoken word; our tone of voice can be more important than the words we say, and our body language may make up over 50% of our communication. If your tone of voice and body language don’t match your spoken words, then you may well be just confusing the person or, even worse, coming across as a liar. 
• The next key point is time. Allow time for the person to consider their response and answer. It is very common for people living with dementia to take more time to respond to questions, and it is important not to cut them off but to allow them to finish responding. If you don’t allow them the time they need, you might be only getting part of the picture and could be demonstrating to them a lack of respect.
• Another key point is don’t underestimate their level of understanding. This is where allowing more time is important. The person has had a life and many experiences before they developed dementia and will most likely have areas of experience and expertise that you may not expect. 

Take the time to get to know the person. What was their past life like? What jobs and responsibilities have they had? Who makes up their family and their relationships to them? It can be helpful to talk to family members to help start the conversation. Start by asking questions relevant to the current activity, for example if it is mealtime ask about their favourite foods. Ask for tips on how they prepared food. You may be pleasantly surprised and grow your own skills. 

Good communication is especially important in this time of COVID because masks not only limit the transfer of COVID but also mask effective communication. They hide your facial expressions and distort your voice. They may also be irritating, disorientating and contribute to anxiety when worn by a person living with dementia. A good starting point to review the concepts highlighted in this column is the Dementia Australia Let’s Talk brochure co-developed with the Dementia Australia Advisory Committee and available at https://bit.ly/ lets-talk-booklet. This resource is also a good example of the principles of co-design, having been extensively designed and redesigned by the members of the DAAC.