What is Dementia?

Dementia describes a collection of symptoms which affects thinking, behaviour and the ability to perform everyday tasks. Functioning can be affected enough to interfere with an individual’s regular social or working life.

Dementia is most common after the age of 65, however, individuals who are in their 40’s or 50’s can also have dementia. The early signs of dementia are very subtle and vague and may not be immediately obvious. Some common symptoms include:

  • Progressive and frequent memory loss
  • Confusion
  • Personality change
  • Apathy and withdrawal
  • Loss of ability to perform everyday tasks

Dementia Types

There are different types of dementia. A confirmed diagnosis of dementia is deemed from a team of health care professionals.

Dementia Type Typical Presentation
Alzheimer’s disease Impaired memory, thinking and behavior
Vascular dementia Impaired language, memory and learning; depression and mood swings.
Lewy Body disease Impaired ability to concentrate and focus attention, extreme confusion, difficulty judging distance (leading to falls), hallucinations, sundowning (behavior changing at night).
Frontotemporal dementia Loss of emotional response, avoiding social contact; difficulty in reasoning, judgement, organization and planning; distractibility, impulsiveness, decline in self-care/personal hygiene.
Alcohol related dementia Problems with memory, personality changes; difficulty with clear and logical thinking on tasks which require planning, organization, common sense and social skills; decreased initiative.
HIV associated dementia Difficulty concentrating, slowed thinking, taking longer to complete complicated tasks, irritability, depression, unsteady gait.

Dementia and its effect on communication

Each person with dementia is unique and difficulties in communicating thoughts and feelings are individual. Some changes you may notice might include:

  • Difficulty in finding words
  • They may speak fluently, but not make sense
  • Writing and reading may deteriorate
  • They may lose normal social convention of conversation (i.e. failure to respond when spoken to)
  • Difficulty expressing emotions appropriately

How to best facilitate communication with individuals who have dementia

There are a variety of ways to facilitate communication between a communication partner and an individual who presents with dementia. Below are the top 10 tips:

  1. Reduce distractions – loud background noises, such as the TV or radio, can often reduce the success of a conversation as it can be distracting for the person with dementia. Ask the person for permission to turn off the TV or radio before initiating a conversation.
  2. Get the person’s attention – before beginning a conversation, always make sure you have got the person’s complete attention. Address the person by name, identify yourself and maintain eye contact. You can use touch to reassure the person and keep their attention.
  3. State your message clearly – use simple words and short sentences. Focus on one topic of conversation at a time. If the person does not respond, try rephrasing the sentence. Avoid the use of pronouns (he, she, they, them), alternatively, use the names of people and places.
  4. Allow time for the message to be understood – make sure to set aside enough time to spend with the person. This avoids rushing the conversation and allows the person time to comprehend and process the information you have conveyed.
  5. Ask simple questions – avoid asking complex, open-ended questions (e.g. “what would you like to do tonight?”). Instead, ask one question at a time and use simple yes/no questions or provide the person with two choice (e.g. “what would you like for dinner, fish or chicken?”).
  6. Repeat for clarification – if unsure of what the person has said, repeat the information back to them to clarify their meaning or ask them to repeat their information.
  7. Distract and redirect – when the person seems to be getting agitated or upset while communicating, try distracting or redirecting their attention. Before redirecting, acknowledge the person’s feelings. For example, “I can see you are feeling upset. How about we take a break/go for a walk/listen to some music”.
  8. Plan your conversation – if the person is better able to communicate in the morning, try to use that time to engage them in a conversation. Think about what you are going to talk about and keep a topic ready. Avoid conversations that rely on short-term memory. Rather, recalling past events can be a soothing activity.
  9. Break down activities into simple steps – this allows the person to complete activities independently. providing the person with simple steps to follow makes a task more manageable.
  10. Use affection and reassurance – holding the person’s hand and providing praise are examples of physical and verbal acts of reassurance and support. These allow the person with dementia to maintain their dignity during times when they may feel confused or anxious.

Most importantly, as the communication partner in an interaction with an individual with dementia, it is important you listen with your eyes, ears and heart. Taking the time to make these individuals valued members of their environment has a profoundly positive effect on their self-esteem and quality of life.

If you have any further questions, or would like the help from one of our therapists, you can contact us on 02 9328 3444 or at info@communicatespeech.com.au. You can also find further information on dementia.org.au or on speechpathologyaustralia.org.au.