Dementia Communication: Letting Go of Logic & Reasoning

Today I'm going to try something new and share my thoughts with you in a video instead. If you'd rather read, I'll also summarize my thoughts down below. I hope this is helpful for you!

As someone's brain deteriorates as a result of dementia, it very often creates new challenges in the realm of communication. What has always worked suddenly doesn't work at all. It can be very frustrating and confusing, and even scary.

Where before, you could quickly and efficiently use a bit of logic and reasoning to clear up a misunderstanding or some confusion, now it is less likely to get through and sink in.

You might find your loved one gets very agitated and upset when you try to correct them or convince them that their reality isn't quite "real"...and that's understandable...nobody likes to be told they're wrong! But they might also have more trouble regulating their emotions and get more easily upset, and that's no fun for you or for them.

So instead of correcting their reality when it doesn't match up to yours, you need to find a common reality.

Let's look at an example. Let's say you go to visit someone with dementia, and they say, "Where have you been? I haven't seen you in so long." But you know you were just there yesterday. And that in fact you visit them all the time.

It might be tempting to correct them, to get defensive if it feels like an accusation, to feel discouraged or hurt yourself, but let's look at an alternate way to respond.

Two steps:

1) Validate.

2) Redirect.

First, imagine that what they’re saying were actually true. How would you feel? Can you imagine that’s how they feel right now? Then respond to that feeling.

Their feeling is real, even if it’s based on their misunderstanding of the world. Trying to correct the misunderstanding won’t help. Responding to the feeling is much more likely to be helpful.

“Were you feeling lonely? I’m so sorry you’ve been feeling sad today. It must be frustrating to have to wait on others to come see you.”

What effect does this have? They’d feel heard, validated, comforted. Like their concerns matter.

If instead you had pulled up your calendar to show them all the days you’d been there to visit, tried to get them to remember your visit yesterday, even if you did it in the sweetest way possible, how would they feel then?

Maybe scared to realize they really don’t remember, embarrassed, confused. They might get upset and argue, cry, get angry. Not what we want, right?

So then once you've validated the realness of their feeling, you can move the conversation on by redirecting them.

This can be anything from starting a new topic, complimenting their clothes, asking them a question, starting an activity, offering a snack. The sky's the limit!

This basic strategy works for lots of different situations that have an emotional component. For example, “I want to go home” when they’re already home or can't go home. “You stole my wallet.” “Where’s my mom?” when mom passed away years ago. Any time a recitation of facts isn't going to be helpful, it often more useful to respond to the expressed feelings, and then move on.

If you try this technique, I'd love to hear how it works for you.