1. Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts stronger than your words. Set a positive mood by speaking in a pleasant and respectful manner. Use facial expressions, tone of voice, and physical touch to help convey your message and show your feelings of affection.
2. Get the person’s attention. Limit distractions and noise, turn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have their attention; address them by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep them focused. If they are seated, crouch down to their level and maintain eye contact.
3. State your message clearly. Use simple words and sentences. Speak distinctly and reassuringly. Refrain from raising your voice in pitch or volume. It may help to pitch your voice lower. If the person doesn’t understand, repeat with the same wording. If necessary, wait a minute and rephrase more clearly. Use the names of people and places instead of pronouns or abbreviations.
4. Ask simple, answerable questions. Ask one question at a time; those with yes or no answers work best. Refrain from asking open-ended questions or giving too many choices. For example, ask, “Would you like to wear your white shirt or your blue shirt?” Better still, show them the choices—visual prompts and cues also help clarify your question and can guide their response.
5. Listen with your ears, eyes, and heart. Be patient in waiting for their reply. If they are struggling for an answer, it’s okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.
6. Break down activities into a series of steps. This makes many tasks much more manageable. You can encourage them to do what they can, gently remind them of steps they tend to forget, and assist with steps they are no longer able to accomplish on their own. Using visual cues, such as showing them with your hand where to place the dinner plate, can be very helpful.
7. When the going gets tough, distract and redirect. When they become upset, try changing the subject or the environment. For example, ask them for help or suggest going for a walk. It is important to connect with the person on a feeling level before you redirect. You might say, “I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”
8. Respond with affection and reassurance. People with dementia often feel confused and anxious. They may be confused about what’s real and recall something that never occurred. Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real), and respond with verbal and physical expressions of comfort, support, and reassurance. Sometimes holding hands, touching, hugging, and praise will get the person to respond when all else fails.
9. Remember the good old days. Remembering the past is often a soothing and affirming activity. Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier. Therefore, avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch. Instead, try asking general questions about the person’s distant past—this information is more likely to be retained.
10. Maintain your sense of humor. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.