How to improve effective communication with patients with dementia?

This is the 4882nd article of Da Yi Xiao Hu

As the population ages rapidly, the proportion of patients with dementia is on the rise. It is estimated that by 2050, the number of patients with dementia in my country will exceed 20 million, which has become a serious public health problem. Currently, there is no specific treatment for dementia. About 75% of patients in my country choose to return to their communities and be cared for by their families after being diagnosed in hospitals. Some elderly people live in nursing homes and are taken care of by caregivers in their daily lives.

Due to cognitive decline, patients experience mental and behavioral symptoms such as wandering, delusions, hallucinations, and aggression, which puts great pressure on caregivers. Patients often forget what they said before and what they are doing afterward. Who am I? Where is this place? What am I going to do? They speak unclearly and even have personality changes, which seriously affects their lives and social life. So how can we communicate effectively with patients with dementia and improve our care skills? Let's learn more about this together.

1. What is dementia?

Cognitive impairment (commonly known as "dementia" or dementia) is a degenerative disease of the nervous system. Common clinical manifestations include Alzheimer's disease and vascular dementia. The main clinical symptoms are cognitive impairment, memory loss, mental symptoms, limb behavioral disorders, etc.

2. What are the main areas of dementia care?

Dementia is like a thief, gradually taking away a person's memory, social and daily living abilities. Therefore, most dementia patients need caregivers to take care of various aspects of their lives, including daily life care, behavioral and mental symptom management, care for other physical diseases, participation in decision-making and communication, etc. The responsibilities of caregivers are to help the elderly maintain health, mental stability, and independence in daily life, and to improve the quality of life of the elderly and their families.

3. What is the key to maintaining quality of care?

As the disease progresses, elderly people with dementia usually experience communication barriers of varying degrees, natures, and manifestations, which are difficult to deal with. Family members and caregivers need to have enough patience and understanding, and master effective communication skills to narrow the distance between each other and make many things more efficient. Effective communication is the golden key to enhancing the relationship between caregivers and patients, and is the key to maintaining and improving the quality of care.

4. How to communicate effectively with patients with dementia?

1. Stay calm

Many caregivers have no experience in caring for dementia patients, and often overestimate their ability to cope with the pressure of caregiving at the beginning. Over time, caregivers will show anxiety, tension, and even resistance. Therefore, before starting to communicate with the elderly, caregivers should first completely relax their minds and stay calm to avoid passing on this anxiety and sense of urgency to the other party. At this time, you can try to take a deep breath and repeat it eight times.

2. Be a good listener

It is not just "listening", but trying to use the five senses to actively listen to what the other person really wants to express and communicate, trying to observe their subtle changes in sight, facial expressions, breathing rate and subtle body movements, and capture their feelings behind them. In this way, they will feel understood and respected.

3. Repetition and empathy

When elderly people with dementia are running out of words and trying to recall what they are saying, caregivers should be patient and not interrupt them, as this will make them feel that they are not there. At this time, restate the important keywords they said to keep the conversation going and avoid making the other person feel uneasy. At the same time, maintain their tone, intonation, and volume.

4. Open-ended questions

Ask questions using the 4Ws (When, Where, Who, and What) to make them easier to answer. Ask fewer whys, which are often difficult to answer. This can increase their sense of autonomy and reduce resistance.

5. Simplify the language

Use simple, understandable, and direct language when communicating. Speak slowly and avoid using complex sentences or abstract concepts. You can also use emphasis, facial expressions, gestures, and body posture to help convey your message so that they can more easily understand your intentions.

6. Eye contact and contact

When talking to an elderly person, do not sit directly opposite them. Instead, sit slightly diagonally opposite them, keep your eyes level with them or even lower than them. This distance, where both parties can reach out and touch, can naturally convey the message "I'm here, don't worry." Physical contact such as hugging shoulders and shaking hands during communication can make both parties feel at ease and trust each other, and bring them closer.

7. Avoid criticism or accusations

Elderly people with dementia cannot understand or express themselves correctly due to cognitive decline. They may feel guilty or frustrated about failures or things they do not do well. At this time, caregivers should not criticize or blame the other person for their mistakes or negligence. Instead, they can encourage them by saying, "It's okay, don't worry!" to eliminate their inner anxiety. For example, "Thank you, Dad, you really helped a lot." Emphasize the things they can still do to help improve their self-esteem.

8. Use hints and clues

Caregivers should first understand the life history of the elderly with dementia and ask them to talk about the past. Old stories often contain important information, such as their values, experiences, unfinished regrets, etc. Use prompts in daily life, such as photos, watches, calendars, music, etc., to assist memory and help understanding.

In short, dementia care is a long and arduous task. By improving the caregivers' communication skills, they can truly understand the patients' thoughts and provide them with full emotional support; negative emotions can be reduced, the burden of care can be alleviated, and it is beneficial to the physical and mental health of patients and caregivers themselves.

References:

[1] Guo Qihao and Zhang Shuying, Comprehensive Management Tips for Cognitive Impairment, 2023.1 ISBN 978-7-5478-5815-8

[2] Cao Qingxia, Luo Yaoyue, Li Yamin, et al. A cross-sectional study on the current status and influencing factors of personal control in spouses of patients with Alzheimer's disease[J]. Modern Clinical Nursing, 2023, 22(02): 16-21.

Author: Yuyuan Street Community Health Service Center, Huangpu District, Shanghai

Huangpu District Geriatric Care Hospital

Yang Jie, Head Nurse

Liu Jing, Head Nurse