Improving Communication

LBD can play havoc with verbal communication and yet the ability to communicate is important for our well being  with our without dementia.

• Language difficulties include the inability to find the right word or using the wrong word, often without even being aware of the substitution.
  
• Weakened facial muscles can cause a low, soft voice, even when the speaker believes he is almost shouting.
• Poor thinking skills. Slower thinking can take as long as 30 seconds to process a question and come up with an answer. Although this may seem like forever to you, your loved one is very busy processing and it does not seem long to them. Inaccurate interpretations are common and negatives may be missed, with directives such as “Don’t sit” seeming the same as “Sit.”
• Other issues may impede good communication: Poor hearing or vision, and depression or apathy decrease anyone’s ability to communicate well. Pain, infections or other illnesses all increase LBD symptoms and decrease language abilities.

Negative feelings, like frustration, confusion, low self-esteem, discouragement or inadequacy, are generated by poor communication. This adds stress, which increases LBD symptoms and makes communication even poorer, with social isolation a very real risk. Here are some ways you can improve communication and help your loved one stay socially connected, healthier and happier:

• Believe. If you believe that your loved one can still communicate, you will likely be successful—if you don’t, you probably won’t be. In support of belief, researchers have long said that comprehension is among the last abilities to go.
• Make the goal about being together, not about understanding or being right. If your loved one calls you Mary and your name is Janice, don’t correct the mistake. It will probably only embarrass or confuse which adds stress—and still poorer functioning.
• Eliminate distractions. Your loved one can focus on only one thing at a time. For a successful conversation, make sure their focus is on you.
• Listen carefully. Sit or stand closely and pay attention so that you can hear their soft voice. Make sure nothing is distracting you either.
• Be alert for non-verbal cues, often much more accurate than words. Check to see if you’ve guessed right: “Do you mean….?”  You can use visual cues too—pointing, touching, smiling, etc. can help your loved one to understand you better.
• Take your time. It takes at least 30 seconds for a person with dementia to process a response. That can seem very long but if you are patient, you may be surprised at what your loved one is able to give back to you.
• Talk normally, but slowly and distinctly. Don’t shout; dementia doesn’t cause deafness. (Shouting also makes you more difficult to understand.) Do talk slowly; remember the processing time issue. Also, talk clearly. Most of us are able to make educated guesses about words that are unclear. Your loved one may not be able to do that. Use positive directives: “Stand” not “Don’t sit.”  These are easier for your loved one to follow.
• Don’t interrupt. Let your loved one complete their response. Interrupting confuses. This includes finishing their sentences or trying to provide the right word. Only do this if asked, or if they have obviously come to a stopping point.
• Limit choices and ideas: Yes or no? This one or that one? Give only one instruction at a time and don’t change subjects.  To many choices or ideas at once overloads their processing ability, resulting in negative feelings, stress and increased symptoms.
• Use humor. This is relaxing and defuses negative feelings—for both of you. Laugh at your mistakes and help your loved one laugh at theirs.
• Check for other issues. How is your loved one’s hearing? Vision? Are they depressed? Apathetic? Are they ill in some other way? Maybe some of the problem isn’t dementia?
• Use touch and affection. When all else fails, this remains. Even when your loved one doesn’t know who you are, a loving touch, a gentle tone of voice and a caring smile are still communication they can understand.