How to communicate with someone who has a cognitive impairment – Part 4
I would again like to thank Kate Smith from Memory Matters some of the information for this blog.
It is important to remember that no two people with a cognitive impairment will communicate or present in the same way, but here are some more ideas that will hopefully help.
People with dementia can have difficulties in planning, putting the plan into action is called sequencing. The often-discussed task is making a cup of tea, there are lots of different stages to this task, which we take for granted and if we get some of them in the wrong order, we do not have tea. So for example, if we pour the water on the tea bag and then boil the kettle, we have a wet tea bag, but no tea. People with dementia can also have problems with other everyday tasks and this includes talking about those tasks. A difficulty planning is around the abstract thought process, I once had a client who held out her hand to me with a 50p in the middle of her hand and she asked me “is this 50p worth a pound?”! She was able to identify the piece of metal in her hand, but did not understand its abstract value and therefore how it worked.
People with dementia can have problems with spacial perception, they will struggle to understand what is close to them or the distance between things, which can impact on how they talk about things. This will also clearly have an impact on how they move about, which will also have an effect on how people treat them (if they look drunk, they might be treated as drunk!).
People hold maps in their head of their environment, so if there is a problem with the map, people can have difficulty finding their way around, except in the most familiar of places. People with dementia who have difficulty finding their way around can begin to go out less or not at all, if they are alone, which can lead them to become isolated and lonely. If they don’t go out, they might need a companion, they need someone they trust and feel safe with and they will happily leave their known environment. When asked about places, they can get confused or muddled and mix places up or have trouble talking about them.
When talking to someone with a dementia, it is more respectful to accept their understanding of their world than correct them, unless it is not possible to do that. So when someone in their 90s talks about their parents as though they are still alive, unless there is a risk to their life, it is better for that person with dementia to also talk about their parents as though they were living. I had a client once whose husband had passed away and she thought he was having an affair and that was why he hadn’t visited, even though she had been told and had attended the funeral, she just couldn’t retain that information. So her family told her lots of different things, but not that he had died, as she just got upset each time, as she re-grieved for him. The family said that he had a cold and didn’t want to pass it on, that he would come next week or that he had come a few days ago and due to her confusion, she accepted all of these excuses and wasn’t upset at either his death or perceived affair!
When talking to someone with a dementia, if you do nothing else, but the kind, safe, smiling person.