Finding a successful way to communicate with someone with memory loss is a creative process and takes a great deal of patience. This article will address some of the issues involved and the strategies for maximizing communication and minimize frustration for everyone involved.

• Use short, direct literal sentences.
• Make certain the most important information comes at the beginning the sentence.
• Avoid compound sentences.
• Use common words.
• Make your statements direct and avoid open-ended questions. For example: don't say, "Is it anyone hungry? Instead try:" I am hungry, why don't I make a sandwich for both of us?"
• Focus on the here and now. Try to avoid conversations that rely on memory.
• Cueing is extremely important. Animate your sentences, point to objects that you are referring to.
• Don't argue. If the person doesn't understand you, reword your question.
• It may take several tries to find the way to make yourself understood.
• Try to speak in the positive and avoid negative comments. Instead of saying, "you can't do that," focus on what they can do.
• Make certain to summarize what has been said. If you are going to make a sandwich, remind them that you just discussed lunch and tell them what you will be doing next.
• Allow time for the person to find the word or words they are searching for.
• Let them be creative in their way of speaking. If they need to say "a thing that takes you places" because they can't find the word for car or taxi, don't correct them. Look for the meaning behind their words and try to make sense of disjointed comments.
• Touching is very important and very reassuring. Make sure it is gentle and loving and does not indicate any signs of restraint.

When someone is very impaired, it is still important to converse to keep the person from withdrawing completely. Make sure you are face to face with the person you are speaking with and keep it at eye level as much as possible. Rely on nonverbal cues as much as possible and keep your tone and demeanor calm and reassuring. Remember, affection and gentle touching can calm someone down and alleviate frustration. They need to feel cared for and respected no matter what state of impairment they are exhibiting.

Try not to patronize or talk to the person as if they were a child. Tune in to how they say things, not necessarily what they are saying. This will give you an idea of how they are feeling inside.

Remember that the decline in memory cognition does not limit intelligence, but only the ability to communicate. Be aware that the person needs to feel respected and listened to no matter what is being said. While the frustration for the caregiver may be extreme, it is important to remember and see the person and treat the person with as much respect and dignity as possible.

When a person becomes agitated during a conversation, it may be a sign of fatigue. It's time to take a break, listen to music, and refocus on something that causes less anxiety and fatigue.

Communicating well under these circumstances is a skill that requires creativity, patience, and compassion. When it becomes difficult for you, take a break, gather your reserves and resume when you can. Your frustration, as subtle as it may seem, is conveyed to the person who is also feeling frustrated and alone.

5/29/98

Emily Carton MA, LISW, is a licensed social worker who works with Elder Options, a private care social service firm in the DC Metropolitan Area. She is also an is an intern in Bibliotherapy at St. Elizabeth's Hospital in Washington D.C.