I rushed into the memory care facility -- I was late -- to visit Jean one sunny Thursday. Jean is one of "My Ladies" with Alzheimer's I volunteer to spend some time with each week. I found her pacing in the lobby and suggested we go to her room to chat a bit. She readily agreed and started walking down the long hallway to her room. I followed behind her.
There wasn't anything wrong with that in itself. What was wrong was that I talked to her all the way to her room. Since she was hard of hearing and I was behind her she didn't hear a word I said. Thus I had violated one of the most important rules for communicating with someone who has dementia -- or even someone who doesn't have it for that matter: Don't talk from behind them.
Sometimes it's not just what you say but also what your body language says. Here are 10 tips for nonverbal communication.
1. Don't Talk From Behind Them: Despite your best efforts you may sometimes forget this one, as described above.
2. Make Eye Contact: This tip is related to the one above. If you're standing behind the person you can't make eye contact.
3. Be at Their Level: If both you and they are standing that's fine. But if they're sitting on a chair it's best if you kneel in front of them. This is especially important if they are in a wheelchair. Otherwise they will have to look up at you and they may feel you're towering over them.
4. Use Therapeutic Touch: People with Alzheimer's may yearn to be touched, but you should first ask them if it's okay. Some people may not want to be touched.
5. Don't make sudden movements: This, too, may scare the person.
6. Offer to Shake Hands Every Time You Visit: They probably won't remember you did it the last time. Put your hand out; they may reach for yours. If not let it go. This tip is related to therapeutic touch.
7. Use Laughter. Alzheimer's is a deadly serious disease. Nonetheless, sometimes laughter is the best medicine. Be sure to have some light-hearted stories to tell the person at each visit. I have found they may counter by telling you a funny story. Just be sure you're laughing with the person, not at them.
8. Use Visual Cues: Point, touch or hand them the item you want them to use. For example, if you want them to drink some water, point to it or put a full glass near them and/or then pick it up and hand it to them.
9. Don't Cross Your Arms: Never sit with your arms crossed. This tends to convey anger just as it does when interacting with a person who does not have dementia.
10. Smile: This is probably the most important guideline of all. You will want to do this at any time (except if the conversation is more serious), but particularly when you're telling the person something pleasant or humorous and when the person is telling you something of a like nature.
Following these simple tips can improve your communication with the person, leading to a more enjoyable visit.
Can any of you think of any additional tips for nonverbal communication?
Marie Marley is the award-winning author of Come Back Early Today: A Memoir of Love, Alzheimer's and Joy, and the co-author (with Neurologist Daniel C. Potts, MD, FAAN) of Finding Joy in Alzheimer's: New Hope for Caregivers. Her website (ComeBackEarlyToday.com) contains a wealth of information for Alzheimer's caregivers.
Note: A slightly different version of this post appeared on the Alzheimer's Reading Room. Some of these tips are from Carole Larkin (a geriatric care manager in Dallas, Texas), Bob DeMarco (founder of the Alzheimer's Reading Room), Teepa Snow (a nationally renowned expert in Alzheimer's caregiving), and the Alzheimer's Association.