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Communication and Patients with Dementia

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

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, CFPS

In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator.  She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist.  She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA. 


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, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3072Level: Intermediate1 Hour
  'Wonderful review and will be quite helpful for this PTA working in my long term facility!'   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, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4096Level: Intermediate2 Hours
  'The instructor was clear and experienced and had interesting anecdotes to share/illustrate the concepts'   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, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3649Level: Intermediate2 Hours
  'very informative and slides were easy understand'   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.

Bullying Among Older Adults: Not Just a Playground Problem
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4692Level: Introductory1 Hour
  'concrete examples of bullying correlated to bullying in younger teens and adults'   Read Reviews
In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.

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

Presenter

Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #3704Level: Intermediate2 Hours
  'good information, practical'   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.

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