Brilliant Minds: Connecting Through Conversation with Dementia
How to talk to someone living with dementia in a way that makes them – and you – feel great. It’s a topic close to many hearts.
Laying the Groundwork: Five Pillars of Good Conversation
Let's start with the bedrock of any successful conversation. These five principles are crucial,
Be Present: This might seem obvious, but in our busy lives, truly being present is a conscious effort. I often find myself making the right noises while my mind is elsewhere! When we're stressed or juggling multiple things, it's easy to be physically present but mentally absent. Even three deep breaths can anchor us in the moment, and consciously slowing down and focusing on your breath is essential when speaking with someone living with dementia.
One such breathing technique is box breathing. Navy SEALs even use it to promote calm before combat. It signals safety to our brains. Here’s how it works:
Inhale: Breathe in deeply, filling your lungs as much as you can, for a count of four.
Hold: Hold your breath for a count of four.
Exhale: Breathe out slowly for a count of four.
Hold: Hold your breath out for a count of four.
Repeat this cycle as many times as needed. It’s a fantastic way to ground yourself and step into the present moment, leaving worries about the past or future behind.
2. Listen Actively: So often, when we "listen," we're formulating our next response. True listening involves fully focusing on what the other person is saying, absorbing their words without immediately thinking about our own contribution. When the person finishes speaking, we can then offer our thoughts or insights. Slowing down this process, focusing on our breath, and truly hearing what's being said makes the other person feel valued, important, and included. For someone living with dementia, who may often feel disconnected or struggle to keep up in fast-paced conversations, this focused listening can make a world of difference.
3. Intend to Understand: Enter every conversation with the primary goal of understanding the other person's perspective. Especially with dementia, the words spoken might not always perfectly align with the intended meaning. Approaching the conversation with curiosity and genuine care allows us to look beyond the literal words and grasp the underlying message or emotion.
4. Look for What Matters: Building on the intention to understand, actively seek out what is truly important to the person in the conversation. Instead of focusing on factual recall (which can be challenging), try to identify the emotions, the interests, or the core of what they are trying to communicate. The shift is from "What did you do yesterday?" to exploring their current feelings or interests. In doing so, we keep the focus on their experience rather than our own need to contribute a similar story.
5. Pause and Embrace Silence: This is a skill many of us have, and one to practice. Sometimes, the most profound moments in conversations with people living with dementia occur in the quiet spaces. Resist the urge to fill every silence. Allow time for thoughts to form, for emotions to surface, or simply for a shared presence. You might be surprised by what emerges when you create space for silence.
Shifting Our Approach: From Fact-Finding to Connection
Let's look at some common factual questions we might ask and explore more dementia-friendly alternatives.
Here are some examples of factual questions and how we can reframe them:
Instead of: "Where did you grow up?" Try: "Where do you like to spend your time?" This allows for imagination and present-moment responses.
Instead of: "Where did you last go on holiday?" Try: "What sorts of holidays do you enjoy?" This is more inclusive and focuses on preferences.
Instead of: "What did you do yesterday?" Try: "How do you like to spend your time?" This shifts the focus to current preferences rather than memory recall.
Instead of: "Where did you get that dress?" Try: "I love the colour of your dress! What colours do you think would suit me?" This offers a compliment and invites their opinion, boosting self-esteem.
Instead of: "What did you think about the match last night?" Try: (As you all brilliantly suggested in the chat!) "Do you like football?", "Do you enjoy watching sports?", "Do you have a favourite sport?" These are more accessible and less reliant on recent memory.
Instead of: "Have you been here before?" Try: "Do you like it here?", "It's lovely to see you.", "Do you feel comfortable here today?" These focus on their present experience and feelings.
Instead of: "How do you know Dave?" Try: "Dave seems like a very nice person.", "Do you know anyone here?", "Would you like to meet Dave?" These offer observations and invitations rather than memory tests.
Instead of: "What have you got planned for the weekend?" Try: "What do you enjoy doing?", "What would you like to do this weekend?", "I hope the weather will be good for the weekend." These focus on preferences and present possibilities.
Instead of (when showing a picture): "What film was this man in?" Try: "Look at this picture. What does it make you think of?", "Tell me what comes to mind when you see this." This encourages association and feeling rather than factual recall.
The key shift here is moving away from questions that rely heavily on memory and towards those that encourage feelings, opinions, preferences, and present-moment observations. This makes conversations more inclusive and enjoyable for everyone.
Navigating Closed Questions: Offering Choices
Let's talk about closed questions. While seemingly straightforward, they can sometimes limit conversation, especially for individuals with dementia. Instead of a simple "Are you watching the tennis?" which might elicit a "yes" or "no" and end there, we can offer choices: "If you had to choose between watching tennis or watching football, what would you choose?" This still offers a limited set of answers, but can spark further discussion about preferences.
Similarly, instead of "Have you ever been to the Lake District?", which might lead to a simple "no" if memory fails, we could say, "Do you prefer a lazy holiday or an action-packed holiday?" If they choose "lazy," we can then follow up with "What would you do on a lazy holiday? Would you read books? Where would be the perfect place to go?" This keeps the conversation flowing in the present.
The Power of Props: Conversation Beyond Words
Finally, let's briefly touch upon the incredible power of props. Instead of asking "Do you remember these?" (which again relies on memory), try simply presenting an object, like a spinning top or something found at the back of the shed. Give it to the person and observe their reaction. Do they try to make it work? What emotions do they express? Remember, communication isn't solely verbal. Actions, body language, and engagement with objects can be incredibly rich forms of connection, sometimes even more so than words. Be curious about what happens next and let the interaction unfold naturally.
"The most beautiful thing we can experience is the mysterious. It is the source of all true art and all science." - Albert Einstein 1
While Einstein was talking about the universe, this sentiment applies beautifully to our interactions with people living with dementia. Every conversation is a unique journey, filled with moments of mystery and wonder. By shifting our approach, by focusing on presence, active listening, and asking thoughtful questions, we can unlock deeper connections and create moments of genuine joy and understanding.
Keep those conversations flowing, and remember the power of connection.