Memory Mondays: Practice Makes Perfect When Communicating with Dementia Patients

Communicating with dementia patients is undoubtedly a difficult endeavor. As dementia progresses, the communication of needs and emotions becomes harder and harder. This leads to misinterpretations, misunderstandings and stress for family members – particularly for the spouses of dementia patients.

But your husband or wife having dementia doesn’t mean that communication is impossible, or even that your marriage is lost, according to the first-ever study to explore and evaluate communication outcomes in both the caregiver spouse and the dementia patient. Researchers with Florida Atlantic University note that practice makes perfect when it comes to communicating with dementia patients.

“There has been very little focus on the patient with dementia’s role in maintaining spousal relationships,” said Christine L. Williams, DNSc, principal investigator of the study and a professor and director of the Ph.D. in nursing program at FAU. “Maybe it’s because researchers assume that the patient can’t have a positive influence on communication because of dementia. We wanted to explore this issue further, especially for couples with a history of special memories shared over decades of marriage.”

Williams designed an intervention program and developed a tool to measure couples’ communication. Over a 10-week period, the communication-enhancement intervention was deployed on 15 patients and their spouses, married an average of 45 years. Williams videotaped and later assessed 118 conversations between the couples to determine the effects of the intervention.

The process unfolded as follows:

– Caregivers we taught to communicate clearly, succinctly and respectfully, avoiding memory tests and arguments.

– Spouses with dementia had the opportunity to practice their conversation skills with the research team.

– Couples were told to discuss a topic of their choice for 10 minutes.

Williams then measured the caliber of communication using the tool she developed, dubbed the Verbal and Nonverbal Interaction Scale-CR (VNIS-CR). As the name denotes, the tool considers verbal and nonverbal behaviors, the latter of which accounts for more than 70% of communication, Medical News Today reported. It also explored sociable and unsociable communication.

Examples of nonverbal, non-sociable items included aloofness, unresponsiveness and staring into space. Meanwhile, examples of sociable items included looking at the space, affection and joking. Social verbal behaviors including coherent conversation and responding to questions, and unsociable verbal behaviors included shouting, cursing and incoherent communication. There were 13 items that were calculated to reach a final score.

“Using this new tool, I was able to confirm that the intervention I used actually worked, and that communication improved in both the spouse and caregiver over time,” Williams said. She was specifically excited about the results because improvement was shown by the caregiver as well as the declining dementia patient, she said.

Given that the majority of dementia patients in the United States are cared for by their spouses, the findings are quite revolutionary. They mean you don’t necessarily have to fear losing all connection in your marriage in the unfortunate event that dementia strikes.

“As patients progress with dementia, couples don’t have to lose everything, especially if they are engaged, if they can still relate to one another and if they focus on the here and now,” Williams said.