How does communication succeed in dementia?

• Don't speak too quickly, but speak loudly and clearly. 
• Speak clearly and in short, concise sentences.
• If the person with dementia speaks dialect, do so if possible. This creates trust because it is the language they know.
• Maintain eye contact. Your gestures and emotions will provide the sick person with additional information that will make the conversation easier.
• Build bridges by calling everything by its name. Say "your son Michael" or "the ceiling".
• Keep introducing yourself if the person with dementia does not recognize you.

• "Now you've forgotten that too!"
• "Can't you remember anything?" 
• "If you misplace everything, you'll just have to look for it!" 

Instead, praise the person for what they can still do or have done well, for example "You folded the napkins nicely. I like that". This gives the person with dementia the reassurance that they are still needed.

Of great importance: non-verbal communication

Verbal communication is not always possible with people with dementia. Always sound out which form of communication the person with dementia can use at the moment and pay attention to the signals of non-verbal communication: at what volume and with what tone of voice are they speaking, with what facial expressions, what gestures, is there eye contact? 

Communication methods: validation, biography work, basal stimulation

Three communication methods have proven effective for people with dementia:

Validation: Staying in relationship instead of being right

Validation is firstly about not contradicting the person with dementia and secondly about interpreting their expressions on an emotional level and not on an intellectual level. Naomi Feil, the founder of validation, attributes the initially incomprehensible behavior of disoriented people to unfulfilled basic needs, for example: 

Example of validation: "I want to go home to my mother"

On an intellectual level, you could reply: "Your mother died a long time ago". On an emotional level, the sick person's statement represents the need for security. A more appropriate answer would be: "Yes, it's best at home. What would you like to do with your mother now?".

Example of validation: "You stole my wallet"

On a mental level, this accusation could cause you to defend yourself or even get angry. On an emotional level, it means that the person with the illness feels devalued. It is better to say, for example: "Yes, money is important. Where did you last see your wallet? What does it look like?".

Biography work: Bringing the past to life

Memory care is of the utmost importance for people with dementia. Pictures, stories, objects, letters and other things awaken memories. With the right "anchors" from biography work, you can help people with dementia to retain their identity and self-image for longer, integrate them better into a social structure and maintain their communication skills. Often they really blossom and a good exchange is achieved. It is important to be aware of and avoid painful life issues.

Ideas for biography work
Many things can be the occasion for a conversation or for positive moments of remembrance:

You can use individual items or put together a "memory suitcase". You can also decorate the room with mementos so that the person with dementia can access them independently of you.

Basal stimulation: connecting through the senses

Basal stimulation is a holistic, body-related form of communication to support severely impaired people (including those with dementia in the last phase) and promote their perception, communication and movement skills. 

The aim is to get the patient to become aware of their own body, as this is an important prerequisite for establishing access to other people and the environment. It is therefore primarily about activating the various sensory areas, as this can significantly improve the quality of life of those affected. 

Basal stimulation works with very simple means. Applied sensitively and at the right time, they can have amazing effects and, above all, lead to more joie de vivre. The basic prerequisite is a trusting relationship without stress. There are various methods of basal stimulation that you can combine:

Basal stimulation through visual stimuli

This form can be implemented very quickly in daily interaction. A walk together, during which attention is paid to many "little things", has a stimulating effect. Changing photos on the wall always create interest and a need for conversation.

Basal stimulation through acoustic stimuli

Telling stories or describing what is happening are simple methods that "force" the person concerned to listen. Music brings back memories and can lead to pleasant conversations. You can also simply talk about the food or the weather. The content or truthfulness (my mother described the same food every day!) is not so important - the main thing is that you communicate!

Basal stimulation through tasting and smelling

Who hasn't experienced this: you perceive a particular smell and memories that have been buried for a long time pop into your head. This is how basal stimulation through smelling and tasting works. You can direct the person's awareness to specific smells, e.g. with a scented candle, spices or nice-smelling creams. Perhaps you know scents that the person has always liked? As the senses of taste and smell are closely related, special flavors are also suitable for stimulating memories.