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Communication and Patients with Dementia

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L

January 29, 2019

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Question

What are some factors, challenges, and strategies for communication with patients that have dementia?  

Answer

Most of our communication is nonverbal. Our verbal communication is only about 7% of what we communicate. Everything else is body language, pitch, tone, sentence structure, loudness, facial expressions, and even silence.

Factors Affecting Communication

  • Family/staff stress and frustration
  • Environment
  • Time
  • Distractions in the environment
  • Medications
  • As dementia progresses, the ability to correctly interpret communication decreases
  • Depression and anxiety

Challenges in Communication

  • Word-finding difficulty 
  • Repetition
  • Unable to read or understand written communication
  • They may revert back to their native language 
  • They may lose their ability to speak in sentences 
  • Loss of the ability to understand
  • Unable to use words

Communication Strategies

So what can you do? Communication strategies include: 

  • Avoid arguing and reasoning.
  • Ask those closed-ended questions or something that we all forced choice. So instead of saying, hey, what do you wanna do today, you can say, would you like to walk outside, or would you like to walk over here, so giving them a choice.
  • Observe the nonverbals.
  • Give them time to respond. Oftentimes we rush them.
  • Speak slowly, clearly, audibly
  • Be ready to repeat
  • Use short sentences 
  • Use their name
  • Use gestures/visual cues 
  • Use adult language
  • Avoid shouting
  • Be an active listener
  • Use eye contact.
  • Use touch.

Do all of those things so that the person knows you are talking to them, you are communicating with them, and then they'll be an active communication partner right back to you.

 

 


kathleen d weissberg

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L

Kathleen Weissberg, OTD, OTR/L, in her 25 years of practice, has worked in adult rehabilitation, primarily in long-term care as a clinician, manager, researcher, and most recently as Education Director with Select Rehabilitation where she oversees continued competency and education for close to 12,000 therapists. In her role, she conducts audits and provides denials management and quality improvement planning training for more than 700 LTC sites nationwide. She also conducts compliance, ethics, and jurisprudence training to therapists.  Kathleen has authored several publications that focus on patient wellness, fall prevention, dementia management, therapy documentation, and coding/billing compliance.  

 


Related Courses

Put Down the Drugs: Evidence-Based Interventions to Reduce Unwanted Behaviors with Dementia
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #3072Level: Intermediate1 Hour
  'Clear presentation that is relatable to working with this population'   Read Reviews
PTs can apply evidence-based interventions to improve dementia care. This session reviews the etiology of common behaviors. Cognitive-emotion, multi-sensory, animal-assisted, and exercise interventions to reduce agitation are discussed as well as specific strategies for improving task-related engagement. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #4096Level: Intermediate2 Hours
  'It was a very thorough course and was laid out in a very organized manner that built on itself from start to finish'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Dementia Management: Techniques for Staging and Intervention
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #3649Level: Intermediate2 Hours
  'uncomplicated'   Read Reviews
This seminar provides an overview of types of dementia including characteristics at each stage, protocols for staging clients with dementia and related treatment strategies. Documentation and treatment planning based on dementia staging results is reviewed. Behavior management and communication strategies for this population are discussed as well as techniques for nursing to follow. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Fall Management: Evidence-Based Interventions for Screening and Intervention
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #3704Level: Intermediate2 Hours
  'This course was very well organized and offered great information regarding fall risk assessment and specific balance programs/exercise to address deficits'   Read Reviews
This session will review evidence-based screening and intervention strategies applicable to a balance and falls management program including research-based exercise programs, environmental modification, patient and caregiver education and balance retraining activities. Falls management program rationale and implementation is also discussed as well as interdisciplinary techniques and strategies to reduce fall risk in the elderly. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Restraint Reduction: Regulations, Alternatives and Therapy Intervention
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Course: #2955Level: Introductory2 Hours
  'Thank you, so informative'   Read Reviews
This session will review updated regulations related to physical and chemical restraints in long-term care. Resident assessment, therapy interventions, and alternatives to restraints will be discussed. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

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