If you’re reading this article, chances are you are close to a loved one who has recently been diagnosed with – or you suspect may have – dementia. While every person experiences dementia differently, there are common symptoms of dementia that can be found in almost everyone who experiences this journey. While your loved one will have moments where they seem like their usual self, there is no cure for any of the known dementias, and the type of dementia your family member or friend is experiencing will not get better over time. Medications can assist in managing symptoms and give your friend or family member a better quality of life, but they won’t reverse the disease.
So, how can you be prepared to best serve your family, friend, or neighbor with dementia? One of the most ideal ways you can support someone with dementia is to understand that their behavior, what they say, and how they react to you may have almost no link to the topic or concept you are talking about – they may be responding to you from a thought they are having that may seem unrelated to you. Still, their response makes sense to them based on their current train of thought, which has been rerouted due to dementia.
What is Dementia?
Dementia is not a specific disease but rather a general term used to describe a group of symptoms affecting cognitive functions such as memory, thinking, and social abilities to the extent that it interferes with daily life. It is a syndrome, usually of a chronic or progressive nature, caused by various brain illnesses that affect memory, behavior, and the ability to perform everyday activities.
It’s also not a “normal” part of aging. Getting older does not mean you will eventually have dementia. Forgetting where you put your keys or what day of the week it is, or taking a bit longer to remember details or facts are parts of aging. Dementia is not being forgetful – losing the memories you’ve experienced and mixing up the pieces of what’s left into one giant pile of thoughts.
While each person with dementia experiences different symptoms – and one person with dementia may have different symptoms than another (because it’s not an all-or-nothing symptom checklist ) your loved one may outwardly express a variety of behaviors that come along with the cognitive challenges of communicating with someone who has dementia.
When to Shift a Conversation with a Person who has Dementia
Just because someone doesn’t remember details doesn’t mean they understand why they can’t remember. They know that you know and remember an event that happened and are unsure why they don’t have that memory. It’s as if someone crawled into their head and erased that memory, only to leave your loved one knowing that they can’t remember and, therefore, can’t have a conversation with you around a lost memory. This is one of the reasons why those with dementia act out – because the anxiety and fear of losing your memories take away your control over your own mind, and that is scary and frightening. If your loved one doesn’t remember an activity you did together, change the subject and talk about the weather or a simple subject that is current or is going on around them.
For example, if you’re talking to a parent about a family vacation and he or she is starting to look stressed, change the subject to the current weather or compliment them on their clothing. You can also walk them over to the menu in their memory care community or walk into the kitchen and ask them what they would like for lunch, dinner, or breakfast the following day. Keeping the conversation easy and light makes for a better memory and keeps their stress levels low. The lower you can keep their stress levels, the less anxiety they will experience and the happier they can be.
Imagine that you are conversing with someone, and they can’t finish a sentence with the thought they had a few seconds ago. This is common in people with dementia. Individuals with dementia often experience difficulties with memory, particularly in recalling recent events or information. While some days or times of day may be better than others, don’t stress your parent or loved one by getting them to recall a memory.
When talking to someone with dementia, the most essential aspect to remember is to empathize with the individual and not expect them to make sense or think that you can “jog their memory” by telling them details of a past memory or asking them if they remember a specific event. Pushing them to remember when their brain is being physically changed by their dementia disease only causes anxiety in those living with dementia and will lead them to act out because of their frustration.
In addition to remembering recent events, dementia affects one’s thinking and reasoning abilities. This decline in cognitive function can make it challenging for individuals to solve problems, make decisions, or understand complex information. People with dementia may struggle to express themselves coherently or to understand what others are saying to them, so when talking to a dementia patient, use simple words and easy-to-understand phrases. However, don’t speak to them as if they were a child – they understand when you’re talking to them as if they don’t know what they are doing.
People with dementia understand the world differently than non-dementia persons, and the thought process in their head – although confusing to onlookers – makes perfect sense to them. Talking to them like a child increases their confusion because they feel that they are expressing themselves in a way that everyone understands. Put yourself in their shoes and respond in a thoughtful and straightforward response that doesn’t degrade or show less respect to the person suffering from dementia.
Individuals with dementia may become disoriented in time and space. They may get lost in their memories surrounding past familiar places and people they have lost (and believe they are currently alive) or lose track of time. You’ll need to meet them on their level and talk to them about their thoughts.
For example, if your mom tells you that she talked to your aunt that morning – the same aunt who passed away years ago – don’t try to convince her that your aunt has passed. This will only heighten her confusion and cause anxiety. Ask your mom how the visit was and whether she enjoyed her time with her sister. Reasoning about the facts of reality with a dementia patient is a lost cause and only creates negative feelings.
You want to go along with the conversation at hand, no matter how silly or nonsensical it seems. Remember, the person with dementia is experiencing their past memories in real time. So, telling them that what they are experiencing isn’t real can have horrible effects on your loved one’s mental health. In addition, this will send the signal that they can’t trust you because you don’t believe what they are saying. Be mindful and compassionate when your loved one with dementia distorts time and place; they are only relaying to you what is natural for them at that moment.
Dementia can also affect a person’s ability to complete everyday tasks, such as dressing, cooking, or driving. People with cognitive disabilities easily get confused because their brain isn’t sending the correct signals, so they don’t understand what is going on around them. Have empathy and guide them gently to where they need to be. Sometimes, this may include redirecting the conversation or behavior to a completely different topic or task they can focus on which gives them an outlet to move forward with their day without adding stress.
One of the most heartbreaking changes you may see in your loved one is the changes in behavior, mood, and personality. Individuals may become agitated, anxious, or exhibit socially inappropriate behaviors that seem unrelated or connected to what’s happening around them. However, the person with dementia may be experiencing a past memory in the current time and space, or their brain may have changed enough physically that their old personality traits may not exist any longer.
While hard to watch, remember that your loved one with dementia still has feelings and understands the world in a very different space. Try to view yourself in their situation and see if there’s a reward, pet, or another activity you can use to redirect them. They may also need space and time to express their frustrations or emotions. Whatever the case, ask them if they can tell you what is wrong. Sometimes, they will know they have pain, anxiety, or there is a noise that is bothering them, but they can’t put the words together to tell you why they are distressed. Work with them to eliminate triggers such as noises and objects that may cause anxious behavior.
Logical reasoning and problem-solving skills can be significantly impaired in individuals with dementia, so don’t expect your spouse or partner to answer your question logically. Again, you want to roll with their point of view and conversation. If you’re asking them how they feel and they tell you that their cat is sick, go with it. Either their cat is sick, or they are reliving a memory of their cat being sick. Either way, it’s a topic that is currently creating stress for them, so try your best to resolve the situation – even if they don’t have a cat (but they believe that they do), offer to take their “cat” to the vet so they don’t have to worry about their pet.
Do You Suspect Your Loved One Has Dementia?
If you believe someone you know and love is experiencing symptoms of dementia, encourage them to seek medical attention for a proper diagnosis. The sooner you can diagnose dementia, the earlier medication can start, which can significantly slow down the disease and give the person suffering from dementia a better quality of life. Early diagnosis gives individuals and their families more time to plan for the future, especially if you find dementia in its early stages, because the person with dementia can have enough cognitive ability to make their choices and preferences known, making this demanding lifestyle transition easier for everyone involved.