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Five Things You Should Learn About Non-Verbal Communication and Dementia

Dementia refers to a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning. Although it’s not a normal element of aging, the risk of developing dementia increases as people age, impacting not only the individuals but also their families and caregivers. Providing care for a loved one with dementia can be emotionally and physically demanding, requiring patience, understanding, and specialized knowledge.


Caring for a loved one with dementia presents a myriad of challenges. As the condition progresses, individuals may experience difficulties with memory loss, confusion, disorientation, and changes in behavior and communication. These challenges can strain relationships and make caregiving overwhelming at times. Effective communication becomes essential in providing quality care and maintaining a connection with the individual despite the cognitive decline.


Dementia can profoundly affect communication skills. As the condition progresses, individuals may struggle to find the right words, follow conversations, or express their thoughts and emotions verbally. Additionally, they may exhibit non-verbal cues such as agitation, restlessness, or withdrawal, which can be challenging for caregivers to interpret. Understanding the nuances of non-verbal communication becomes crucial in bridging the communication gap and meeting the needs of individuals with dementia.


Non-verbal communication plays a vital role in caregiving for individuals with dementia. When verbal communication becomes challenging, non-verbal cues such as facial expressions, gestures, body language, and tone of voice can convey emotions, needs, and intentions effectively. By recognizing and responding to these cues, caregivers can enhance understanding, build trust, and improve the overall quality of care for their loved ones.


So, here are 5 things to know about non-verbal communication and dementia:


  1. You may need to adjust your assumptions.

When someone close to us develops dementia, we intuitively still expect to communicate with them in the same ways we always have. Many people expect dementia to mostly entail forgetfulness – our loved one calling us by the wrong name, misremembering who we are, forgetting important life events and relationships, and so on. While this can often be true, one of the most difficult adjustments to make is having to adapt to a person’s changed mannerisms. People with dementia can revert, in many ways. In extreme cases, they can revert to speaking their first language and forget a language they learned and used later in life. More commonly, this can present as reverting to an old way of speaking, forgetting newer slang and expressions, and going back to an entirely different type of body language. In the later stages of dementia, you cannot always assume that your loved one can still easily recognize your subtle facial expressions or changes in your tone of voice as a close person would.


  1. Face, body, and distance.

Body language can play an enormous role in conveying the real tone and meaning of what we’re saying, regardless of who we’re communicating with, and this includes several components.

·      First, facial expressions: A face can convey sadness, concern, urgency, etc. Smile, maintain eye contact, and show warmth and reassurance through facial expressions to convey positive emotions and foster a sense of security. Remember that with advanced dementia, some people can lose the ability to read more subtle facial expressions and if that is the case, more exaggerated facial expressions can be helpful, even if they feel a bit inauthentic.

·      Next, gestures and body positioning: Adopt open and relaxed body language to create a comfortable environment and encourage communication. Avoid crossing your arms, tapping your foot, or appearing tense, as it may escalate agitation.

·      Third, proximity: When we can see that a person is having a hard time understanding what we are trying to convey, we can unthinkingly move closer to them, but this can feel intimidating and invasive. Be mindful of your loved one’s personal space, stay within their line of sight, and maintain close physical proximity without crowding them during interactions to facilitate engagement and connection.


  1. Tone and pitch.

Many people resort to an infantilizing, higher pitch when addressing elderly folks who have difficulty communicating (and sometimes, those we perceive to have difficulty communicating). It’s important to find a gentle tone of voice without using the signature high pitch and avoid what is referred to as baby talk. If, and only if, a person with dementia is clearly having a hard time understanding your normal way of speaking, try speaking slower and clearer. Avoid speaking too loudly or abruptly, which can cause confusion or distress.


  1. Comfort and validation.

Offer comforting touches such as holding hands, gentle hugs, or a reassuring pat on the back to convey love, support, and reassurance, if it feels appropriate. Physical touch can be a great anchor to reality as well as a signifier of a safe space. Acknowledge the individual's emotions and validate their experiences, even if they cannot express themselves verbally. This fosters a sense of dignity and respect.


  1. Visual Aids.

When verbal communication is particularly challenging or impossible for your loved one, visual aids can be a great tool to help them convey their needs, thoughts, and ideas. Using gestures, going through photos, using images, or writing cues to supplement verbal communication and enhance understanding can be tremendously useful from a practical viewpoint as well as for delaying further cognitive decline.


Working with the elderly and their families, our team knows the emotional hardship of living through the deterioration of communication between you and a loved one with dementia. We encourage you to be patient and flexible in your approach. Practice active listening by giving the individual your full attention, nodding, and responding empathetically to their non-verbal cues to show understanding and support.


Navigating communication with a loved one with dementia can be challenging, but understanding the nuances of non-verbal communication can greatly improve the caregiving experience. By observing and responding to non-verbal cues effectively, caregivers can enhance understanding, foster connection, and provide compassionate care tailored to the individual's needs. In the journey of caring for someone with dementia, effective communication, both verbal and non-verbal, becomes a cornerstone of maintaining dignity, respect, and quality of life.


If you need assistance or advocacy in caring for an aging loved one, visit and request a free consultation call with one of our geriatric care management experts.


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