As part of continuing education for staff, Springwell recently welcomed Nicole McGurin, MS, CDP from the Alzheimer’s Association to lead a workshop on communication. Our goal is to build our staff capacity to help all caregivers learn strategies and approaches that facilitate better communication with individuals who are at various stages of Alzheimer’s disease and related dementia. A key point according to Nicole is that, “People miss being able to talk with their loved ones as they used to.”
After first detailing the communication changes that are likely to occur in early, middle and late stage dementia, Nicole then taught strategies, tips and examples of how to more effectively communicate given the particular challenges of each stage.
Early on in the disease, one on one conversations with no distractions are easier for people, while the phone can be difficult because there are no verbal cues. It is a good idea in early stages to let the individual search for their words rather than trying to finish their thoughts unless they want you to assist. Nicole encourages patience with repetition by reminding that “it is not their fault; it is changes in the brain.”
As the disease progresses, most people will have more changes relative to how they communicated before the dementia. At this stage, most still have emotional awareness of changes in their ability to express themselves and communication challenges can be frustrating for them. Some helpful communication strategies for loved ones and caregivers at this stage include: provide visual cues and gestures, turn negatives into positives, avoid quizzing them about things they likely don’t recall (what did you have for breakfast), and avoid open ended questions.
In the later stages of the disease, connecting with the individual through senses can be meaningful: touch, sight, sound, smell, taste. Nicole suggested engaging through activities during a visit. Ideas included playing a piece of music that the person liked previously, enjoying a serving of a favorite ice cream, doing a gardening related activity. While the individual may not recognize you, they may be more relaxed or alert during the activity and Nicole noted that can be regarded as a meaningful interaction. It is important that caregivers establish reasonable expectations of their loved ones and of themselves.
Nicole provided case studies and facilitated discussion about communication strategies for each dementia phase, and techniques to handle difficult, but frequently necessary topics at each stage of disease like: going to the doctor, deciding when it is time to stop driving and making legal and financial decisions. This session concluded with a robust Q& A session that demonstrated the value of the session to Springwell staff, and the importance of the training to better serving the hundreds Springwell families impacted by Alzheimer’s and related dementias.