“What we’ve got here is a failure to communicate.”

The deterioration of the brain with dementia tends to also lead to a deterioration of the ability of a demented individual to express him/herself verbally.  Language becomes more difficult – both speaking it and comprehending it.  Those with dementia often mix up or omit words/phrases and /or replace other words or non-sensical speech for what they are trying to say.  The phrase “word salad” is used to explain the disjointed communication that happens with many demented individuals and those with dementia are often labeled as “verbal” or “non-verbal.”  This leads those of us in the non-demented world to assume that the failure to communicate with someone with the disease is somehow the fault of the person with dementia.  However, if we agree with communication research that normal communication is only about 10-30% verbal and about 70-90% non-verbal, then I would question who is really at fault in the communication process?!

Carl Rogers stated, “Man’s inability to communicate is a result of his failure to listen effectively.”  Are we listening effectively to those with dementia?  Probably not – especially if we are only “listening” for the verbal.  The failure to communicate is often with those of us who are non-demented because WE are the ones having the most difficulty interpreting what is being “said” to us – whether verbal or non-verbal.  And, often OUR inability to understand and respond appropriately leads to their frustration, agitation, and behaviors.  Therefore, it is important for us to develop and hone OUR communication skills and act as communication detectives when working with individuals with dementia.

I think that the best way of looking at dementia and communication is to examine what WE are doing wrong – not to discuss what those with dementia are not doing right (they can’t help it…WE can).  The following is a list of OUR communication failures – things that we do or don’t do in regards to communicating with those with dementia:

1.  We argue with them or try to correct them

2.  We use the wrong approach and/or ignore personal space

3.  We ignore them (or their requests)

4.  We are dismissive of them (or their concerns)

5.  We try to reassure them (not allowing them to express emotions)

6.  We distract them or redirect them without addressing their issues first

7.  We tell them what to do (don’t offer them choices)

8.  We bombard them with information or too many choices

9.  We talk about them or through them (not to them)

10.  We perform tasks without informing them of what we are doing

11.  We only listen to the verbal and ignore the non-verbal

12.  We fail to see the world from their perspective

13.  We use only one of the senses

14.  We don’t pay enough attention to external stimuli

15.  We use negatives

16.  We use sympathy (rather than empathy)

17.  We try to fix the problem rather than to listen to the real issue

18.  We try to get them to remember

19.  We lie to them or impose our ideas on them

20.  We are afraid of behaviors (don’t see them as a form of communication)

Each of these will be discussed in more detail in the posts to follow.  Stay tuned…

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