By Stephanie Demello, MS, CCC-SLP
Speech-Language Pathologist, Southeast Pennsylvania

Being a speech-language pathologist who has had the pleasure of spending the majority of my career working with patients with dementia, I understand the challenges that come with communicating with this population. 

Patients with dementia struggle with the ability to process information, find the right word, recall pertinent information, and just make their thoughts known. In the words of Teepa Snow “Dementia does not rob someone of their dignity; it’s our reaction to them that does.” So how do we change that?

8 Tips and Tricks for Communicating with Patients with Dementia

As clinicians, our nature is to want to fix things. But how do you fix something when you can’t communicate with a person who has dementia? It’s not easy. Some days you may feel like you are at a dead end, while others make you feel like you moved mountains. 

A lot of communication issues could stem from our approach. I want to give you some tips that help make communication easier and build a better rapport with your patients. Some of the tips and tricks that I have found helpful have come from the great Teepa Snow and taking many of her continuing education courses, others have just come from years of practice as an SLP. 

1. Establish a Connection

This may be the most important tip in building a positive work environment. It is key to strengthening a relationship and gaining trust. Having a strong relationship will help you tailor your communication strategies to each individual’s needs. 

2. Simplify Your Language

Using simple and clear language at a slow rate makes it easier for a patient to understand what you are trying to convey. Avoid using jargon, sarcasm, slang, and colloquialisms. Try not to use complex sentences or speak over them. 

3. Be Patient

Remember the 90-second rule? Give patient’s at least 90 seconds to process what you are asking and allow them to react. If you keep asking your patients to complete a task without letting them process it, your request often gets lost in translation. 

4. Verbal Cues

Verbal cues are another great resource to add to your toolbox. They help increase communication by providing individuals with prompts to guide them to the desired responses. I will list several helpful types of verbal cues that can be incorporated into therapy. 

• Direct verbal cues are short instructions telling the patient exactly what to do. 
• Repetition increases memory during a task, but keep in mind the 90-second rule and patients may require some extra time to complete tasks. 
• Descriptive verbal cues can be useful when trying to explain a game or activity to a patient by providing a picture to the patient verbally. 
• Prompting is another type of verbal cue that can be used to assist a patient with recall by providing hints. 
• Focused verbal cues aid patients in maintaining a topic or a task. 

5. Visual Aids

Visual aids can be very helpful in facilitating communication with patients with dementia. Visual cues can include gestures and facial expressions and also can encompass pictures, videos, and other visual aids. 

Some of these tools are common practice for SLPs such as picture boards or communication books to assist patients with expressing themselves and helping them understand what others are saying.

6. Positive Language

Using positive language can help create a positive environment and reduce anxiety during your therapy sessions. Try to avoid saying things like “No” and “Don’t” and try not to be confrontational. So, instead of saying “Don’t touch that” try saying “Let’s focus on something else”. Remaining uplifting and encouraging will get you a lot further during your therapy sessions. 

7. Reminiscence Therapy

Reminiscence therapy formulates upon the idea that past memories impact patients and create a positive environment. It can be extremely helpful when trying to get a patient to do an exercise or a task. 

For example, you could turn on your patient’s favorite song and have them complete marches to encourage participation in exercise. You could have your patient tell you about an activity or a game they used to play as a child and try to incorporate that task to increase participation. 

8. Keep a Routine

My last suggestion is to keep a routine. It can help reduce anxiety and confusion. Creating a schedule for daily activities or even a schedule for your therapy session can help a patient feel more in control and comfortable.

Don’t Underestimate the Value of Effective Communication

Communicating with someone with dementia or Alzheimer’s can be challenging, but it’s essential for maintaining a connection with your patient. Changing just a few small things can go a long way. Simplifying your language, using appropriate cues, being patient, using positive language, incorporating reminiscence therapy, and keeping to a routine will help create a positive relationship with your patients.