Most Effective Strategies
Not all communication strategies are equally effective. A 2003 study by Small, Gutman, Makela, and Hillhouse examined the effectiveness of various communication strategies mentioned in the Alzheimer's disease caregiver literature and those strategies used by family caregivers during general day-to-day activities. While all of the following strategies may seem intuitively appealing, many lack the research to support their use and one has even been shown to have a negative impact on communication and should not be used. An outline of the findings of this study are shown below to assist you in selecting the most effective communication practices when communicating with your loved one with dementia.
Ten communication strategies frequently mentioned in the AD caregiving literature:
Most commonly used strategies as reported by family caregivers:
Most effective strategies:
Neutral strategies:
Strategies to be avoided:
Ten communication strategies frequently mentioned in the AD caregiving literature:
- Eliminate distractions (e.g., TV, radio).
- Approach the person slowly and from the front; establish and maintain eye contact.
- Use short, simple sentences.
- Speak slowly.
- Ask one question or give one instruction at a time.
- Use “yes/no” rather than “open-ended” questions.
- Repeat messages using the same wording (verbatim).
- Paraphrase repeated messages.
- Avoid interrupting the person; allow plenty of time to respond.
- Encourage the person to “talk around” or describe the word he is searching for.
Most commonly used strategies as reported by family caregivers:
- Simplification of their speech
- Paraphrasing what they say
- Not interrupting their spouses
- Controlling environmental distractions
- Engaging their spouses’ attention
Most effective strategies:
- Eliminating distractions
- Speaking in simple sentences
- Employing yes/no questions
Neutral strategies:
- Repeat messages using the same wording (verbatim).
- Paraphrase repeated messages.
- Avoid interrupting the person; allow plenty of time to respond.
- Encourage the person to “talk around” or describe the word he is searching for.
- Approach the person slowly and from the front; establish and maintain eye contact.
Strategies to be avoided:
- Speaking more slowly: Speaking more slowly has actually been shown to have a negative effect on communication between the caregiver and Alzheimer's patient. This is most likely because longer sentences require greater working memory to support this cognitive demand. By increasing the length of the utterance by slowing down rate of speech, the task for the Alzheimer's patient becomes even more complex and challenging.
Small, J. A., Gutman, G., Makela, S., & Hillhouse, B. (2003). Effectiveness of communication strategies used by caregivers of persons with Alzheimer's disease during activities of daily living. Journal of Speech, Language, and Hearing Research, 46(2), 353-367. doi:10.1044/1092-4388(2003/028)
Copyright © 2013, 2014 Lee Ann Faria. All rights reserved.