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In part 1 on compassionate communication, I spoke about the impact of verbal, non-verbal and the external environment on communication.  I picked out 4 tips for improving communication:

  1. Recognise that process speed slows so allow time for the individual to answer. Considerable time.
  2. Holding information becomes harder so speak slower, clearer and offer less information per speech.
  3. Recognise that non-verbal communication is the principle form of communication.  Make sure your non-verbal signals suggest positivity & safety.
  4. A loud, busy external environment can increase confusion and make any conversation difficult.

In this 2nd part on communication, I want to expand on a couple of these topics.

Old Styles No Longer Work

Old communication styles no longer work.  This is something I discuss with families regularly.  Many couples have over decades built up a pattern of communication which is the default process.  This may involve bickering, logical discussion, sarcasm or teasing.  However, as someone’s cognitive decline increases their ability to pick up on sarcasm or to follow a logical argument and retaliate in bickering decreases.  The common response will often be to say no, to refuse or an argument may begin to escalate.

Dementia is an invisible illness and so easy (particularly at the start) to forget or underestimate the damage it has done to the person’s brain.  They now struggle to retain new information, often can struggle to follow conversation or unpick complex language.  It requires the carer or family member to build a new way of communicating and to not become frustrated when old communication patterns end in frustrated arguments.

If someone living with dementia doesn’t agree or want to do something they don’t have the complex communication skills to reason or argue logically and will often just refuse.  Equally if what they do say is inaccurate or out of sequence that is no longer important.  For happy communication I teach two things:

  •       * First avoid disagreement at all times or as much as you can.  They can’t argue so agree with them and move around the subject.
  •       * Second recognise their pleasure in communication (even inaccurate unusual communication).  Even if the information is incorrect or makes no sense we all like communicating so take pleasure in all forms of communication.

Non-Verbal Communication

As I mentioned in part 1 this is the principle form of communication and should be a focus for successful happy communication.  In most situations, our non-verbal communication is seeking to either connect or seek a sense of safety.  As social animals we co-regulate in small groups or communicating 1:1. This means that our physical reactions subconsciously mimic or mirror each other’s emotions.  This occurs down to the speed and beat of our hearts, the speed of our breathing and the matching of emotions.

Someone living with short term memory loss can be (not always) in a constant state of anxiety or slight confusion.  Scared of a world they can no longer fully understand and socially unconfident.  They look around the world seeking connection, security and certainty and this is why our non-verbal language is so important.

Some examples of positive non-verbal communication:

  •      * Eye contact that includes a smile through the eyes and in the mouth.
  •      * Big smile, genuine laugh.
  •      * Tone of voice that is happy, positive and gentle
  •      * Calm sound to the voice and a comfort in silence
  •      * To be on the same eye line either sitting or standing.
  •      * Touch – gentle, non-intimate (if not family) on hand, shoulder, knee
  •      * Agreement sounds – hmmm, yes, I agree (regardless of truth)
  •      * Create a feeling that they are in control and what is happening is correct.
  •      * Hand gestures that are open, stance and body form that is open, face that is wide and open.

All non-verbal actions are seeking to co-regulate emotion.  However, occasionally you may need to actively consciously regulate and there are actions you can take.  There are small exercises to boost mood, these include:

  •     * Looking in the mirror (or at each other) and opening our arms and creating the biggest smile we can.  The wider the arms and sillier and bigger the smile the better.  By watching someone do that we will do it ourselves and feel better.
  •     * Equally fake laughing, with a big smile will turn into real laughter.
  •     * Or there is a simple tapping exercise that can help to wake up and reduce fight and flight response.
  •     * Deep humming coming from our tummies and through our chests feels silly but helps to improve emotions.
  •     * Finally breathing exercises like the 5-7 Breathing Technique (shown in all Google searches).

In Conclusion

There is so much more to say about communication and The Ness Care Group do courses and teaching around validation therapy and how to communicate well with those living with memory loss so please do get in touch.

However, at the core of everything is to recognise that this individual living with dementia has a brain that has been irrevocably damaged they can no longer communicate in the same way and will often feel incredibly scared, confused and anxious.  We must therefore change for them and enable the world so they can feel safe and loved.

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