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BJB EDUCATIONAL SERVICES
Barbara J. Bridges, R.N., M.S.N., M.S.H.C.M., M.B.A.
Article on Communication Techniques
Please click on any underlined text for further information.
This article is based on information found in Chapter 5, Therapeutic
Caregiving: A Practical Guide for Caregivers of Persons with Alzheimer's and Other
Dementia-Causing Diseases, by Barbara J. Bridges.
One half of Americans over the age of 85 have dementing illness caused by
Alzheimer's disease, multiple small strokes, Parkinson's disease, or other neurological
diseases. Over 4 million people in the United States are afflicted with Alzheimer's
disease alone. Almost everyone, either directly or indirectly, knows someone undergoing
this devastating loss of cognitive functioning.
We often think of dementing illness as a problem with memory loss. Memory
loss is only part of the problem. As the brain deteriorates, thinking and judgement
abilities (cognitive abilities) decrease, the capacity to adapt fails, and finally
deterioration of all bodily functions ensues. Caring for persons with dementing illness
presents many challenges to caregivers. Among them is the difficulty in communicating with
persons who seem unable to understand or respond to others.
"Imagine not being able to remember the beginning of this sentence by
the time you reach the end." This sentence, developed by the Alzheimer's Association,
Western and Central Washington chapter, depicts the very essence of the problems in
communicating with someone with dementing illness. Specific problems are: short term
(recent events) memory loss; inability to concentrate; and extremely slowed response to
stimuli. These problems require those of us who are communicating with persons with
dementia adapting our style so the person with the deteriorating brain can have time to
understand and respond to us. Can you imagine yourself knowing what you wish to
communicate and not being able to express your thoughts?
Specific tips for adapting our communication style to facilitate
communication with persons with dementing illness follow:
 | Keep noise to a minimum to allow for complete concentration. Make the
room quiet, or take the person to a more private setting. If the television is on, the
grandchildren are running around the house, or the person is in a large group with much
conversation, he/she will not be able to respond and communicate.
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| Check for hearing and understanding before communicating by giving a
simple instruction that will require a response. The person may have a physical or
mechanical hearing problem which needs attention. Additionally, there are many ups and
downs in cognitive functioning levels, resulting in relatively good ability to communicate
at times, and great difficulties at other times.
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| Locate yourself in front of and at eye level with the person, and use
touch to assist the person to focus and concentrate.
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| Talk slowly, calmly, and deliberately, giving the person time to
respond.
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| Use short sentences--5 or 6 words at the most. In later stages, just 2
or 3 words--subject and verb--may be all that the person can assimilate and respond to.
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| Repeat unanswered questions or comments using the exact same words.
Remember poor concentration and slow response to stimuli. Several repetitions may be
necessary before you receive a response.
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| When asking for a decision, give the person two choices only. An open
ended question such as, "What kind of juice would you like?" is too complex for
the person with dementing illness to answer. However, if you ask, "Would you like
apple juice or orange juice?" the person will probably respond.
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| Communicate with warmth, honesty, and feeling. Persons with dementing
illness are keenly sensitive to facial expressions, body language, and voice tones.
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| Communicate about subjects which may still be in memory--those from
earlier years. If you ask persons with dementia what they had for breakfast, they probably
can't respond. If you ask questions about their childhood, their profession, etc., you
will probably get a response.
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| Train visiting family and friends in communication techniques so
communication can be more meaningful for all parties.
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If you are interested in sponsoring a seminar/presentation,
Call: (800) 799-3414
or
Ms. Bridges: bjbservices@prodigy.net
   
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