I'm reposting this separately so we can just refer to it when new people need information on combative behaviors and communication.

Dementia Communication 

      The communication skills of the caregiver can often mean the difference between a person with dementia being cooperative or combative. Unfortunately many times family caregivers and even professionals find it difficult to practice good communication skills. I think this is especially difficult for family members who have known the person with dementia for all of their lives. They develop patterns of communication based on personalities and the roles people play in their lives (parent, sibling, child, friend etc)

     When someone has dementia, the roles change (a parent may now need to be supervised for example) and because of the dementia, the communication needs to change as well. 

      If we, as caregivers, are not careful, our body language (tone of voice, facial expression, the way we carry ourselves etc.) can send a stronger message than what we are verbally saying. So without meaning to, we can create fear, anger or embarrassment even though we may be saying the right things. For instance, a caregiver may be reacting to the thought of having to clean a dirty diaper and on some level may be angry she has to do it. It's hard to disguise this while communicating with the person who has dementia unless she makes an effort. These mixed messages lead to resistance to care and even combative behaviors. Anyone who works with dementia patients needs to monitor tone of voice, facial expression, body stance etc. Talking nicely with an expression of disgust or anger (and maybe not even realizing we are doing it) causes mixed messages. When this happens, the person with AD will go with the body language.  

Good communication techniques include: 

Approaching the person with dementia from the front. 

Making sure the light is on our face so the person with dementia can clearly see us and use visual clues as well as what they hear, to understand what we need them to do. 

It's helpful to sit next to the person at eye level. Standing above them is intimidating. 

Speak slowly and clearly in short sentences. A sharp voice or fast speech is also intimidating. 

Use treats to change moods (if someone is upset or anxious etc.) People with dementia rarely get treats. When we ourselves are upset, most of us have things we do to make us feel better (eating chocolate for example). but dementia patients cannot do this. So we should do it for them.  

Treats can also be used as bribes to get them to do something. Ex: "Dad, I have some apple pie for us to eat right after you have your shower." 

Treats may be helpful as distractions: EX: "Dad we don't need to worry about what's in that room right now.There is a football game on we can watch. lets go in the living room". 

Learning how to communicate well and use distractions and treats will help make caregiving a lot easier and also help the person with dementia to have a higher quality of life with few or no combative episodes 

Hope this helps

Stephanie

Thank you.

I love that you repost this periodically!

Stephanie,

I'm thinking that some of these suggestions also work well with children.  Thanks for sharing.  Veronica