The holidays are the time of year when families come together and to catch up and fellowship. For families with a loved one with dementia, communicating during the holidays is not always easy.
Dementia is an umbrella term that describes a change in brain function that interferes with a person’s ability to function and do everyday activities.
As the disease progresses, so do the symptoms. A family member who still had most of their speech intact last year may have progressed in their disease and not be in the same condition this year.
What they will still have, however, is the ability to pick up on your emotions, tone of voice, gestures, and body language.
“They can read you, and they can read you until the end of their life,” said Hollie Glover, director of education and family support services at the James L. West Center for Dementia Care.
What does that mean for you and your loved one this holiday season? You have to meet your loved one where they’re at.
“We have to go to their world because they can’t come to ours,” Glover said.
The James L. West Center’s education department offers tips for communicating with individuals living with dementia through every stage of the disease.
Early Stage: Fostering Engagement and Support
The early stages of dementia bring the beginning of cognitive changes. You may find your loved one writing notes to themselves to compensate for their declining memory or frequently at a loss for the right word. However, this does not mean that they are unable to be a part of the conversation.
Glover advises never excluding anyone with dementia. Rather, she says, accommodate the disease. This means:
- Slow down and speak directly to them
- Give them plenty of time to process and respond
- Use simple commands, broken down into small sentences
- Look for the feelings, emotions, and needs behind their words
Above all, says Glover, focus on what they can do, not on what they can’t. In the early stages of dementia, the focus is on normalization.
During the holidays this may look like accepting their offer to help. While there may be some tasks your loved one is now unable to tackle, they can always stir batter, peel potatoes, set the table, or help hang ornaments on the tree.
Middle Stage: Adapting to Increasing Challenges
Dementia’s middle stage brings more pronounced difficulties in communication. This is where the shift from normalization to support happens, as your loved one will need assistance more with their everyday activities, lose track of their thoughts, and have trouble understanding what others are trying to communicate.
Like the early stage, though, this doesn’t mean you need to exclude your loved one from the conversation. Instead, your communication needs to change to meet their changing communication needs.
- Reduce distractions and engage in one-on-one conversations
- Stand directly in their line of sight, not towering over them
- Get their attention by calling their first name
- Ask yes or no questions one at a time
- Use more gestures and visual cues
As in the early stage, look for the feelings, emotions, and needs being expressed by your loved one. For example, if their brow is furrowed and they’re hitting their stomach, there’s a very good chance they’re in pain.
“Their words may be saying no if you ask if they’re in pain, but their body language is saying yes,” Glover said. “A furrowed brow always means something’s wrong.”
Late Stage: Emphasizing Nonverbal Communication
The late stages of dementia are the most difficult as severe language breakdown occurs. While your loved one may have minimal to no words left, it’s important to remember that they’re still connected to their feelings and emotions.
At this stage, nonverbal communication is key to nurturing your relationship.
- Listen to their favorite music
- Hold their hand
- Use touch to communicate compassion, reassurance and love
- Make eye contact and actively listen
This can be challenging during the holiday season when we’re all so busy, but simply being in the same room as your loved one can provide them the comfort and support they need.
All Stages: Stay Patient and Compassionate
Every person with dementia has a unique experience with dementia. By adapting your communication style to match your loved one’s, you can significantly improve their quality of life.
While it may seem frustrating at times, it helps to remember that a person with dementia is saying and doing things that are completely normal for a person with dementia. “They’re not giving you a hard time. They’re having a hard time,” says Glover.
As we head into the holiday season, remember your loved one wants to participate in the festivities and is doing the best they can with what they have.
For more tips on communicating with your loved one this holiday season, explore the James L. West Center for Dementia Care’s free caregiver education series.
