Meaningful, quality visits with dementia sufferers


By Micha Shalev

If you’re headed out to care for or spend some time with a friend or family member who’s is the middle stages of Alzheimer’s or another dementia, consider these tips as your guide.

Know what to expect.

shalev_hsIncrease the likelihood of a positive visit by setting realistic expectations. The middle stages of dementia can be difficult. Sometimes people experience challenging behaviors such as delusions or anxiety, or they become easily upset. They might not be able to recognize you right away or come up with your name. Knowing that these symptoms are part of the disease and not a reflection of the person’s relationship with you can help you to respond well to them and ensure that the visit is positive.

Communication strategies — Listening:

•Show interest and respect by maintaining eye contact and relaxed body language.

•Be calm, patient and don’t interrupt. Be focused on the present and all of the possibilities that you have to communicate meaningfully right now.

•Read facial expressions and gestures, for they are likely to reveal more than the person’s words. Gestures may replace forgotten words.

•Enter their world with them. Be an actor in their “play.” Remember that whatever they are expressing is actually where they are in time. (Their past is their present, the present is their future, and the future doesn’t exist because they can’t store memory.)

•Offer comfort and reassurance, especially when the person is having difficulty expressing him or herself. Offer praise for success in accomplishment (e.g., completing a thought, reciprocating in an activity).

•Offer your best guess if you don’t understand what is said and the person is becoming agitated. Try again if they say “no” to a guess.

•Avoid criticism, correcting and arguing. This can be traumatic to the person.

•Reminiscence is a key ingredient for success. Do things to initiate fond memories such as humming a favorite song, talking about a pet, offering a familiar photo or object for a story. Smells, taste and touch are also strong memory triggers.

•Engage the person’s “body memory” — called the “chaining” technique — to help them initiate or sustain an activity. For example place a glass of water in the hand.

•Use a “bridging” technique, a sensory connection that increases focus and attention and decreases anxiety.

Communication strategies — Speaking:

•Treat the person as an adult and don’t be condescending.

•Use short, simple, familiar words and sentences.

•Ignore verbal outbursts if you are unable to respond positively.

•Other forms of communicating include songs, touch, food and joint activity.

•Go to their eye level and be sure that they can see you clearly when you talk and listen.

•Take on a similar posture to theirs to develop rapport non-verbally at their level.

Research has demonstrated that it’s not just the memory that matters here; it’s also the emotion created by a positive visit. What’s important to note is that the positive emotion from an encouraging and supportive visit can last much longer than the specific memory of that visit.

You may have impacted that person’s whole day by changing his or her feelings and behavior. Although he or she might not be able to recall that you visited, the feelings you created in him or her can change how he/she interacts with others and improve the person’s mood.

Micha Shalev, MHA, CDP, CDCM, is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester. He is a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker on Alzheimer’s and Dementia training topics. He can be reached at 508-853-8180 or by e-mail at or view more information online at