Struggling to be Heard: Practice Active Listening With Loved Ones Who Have Alzheimer’s

If your loved one in hospice care in San Francisco and elsewhere has Alzheimer’s or other form of dementia, it can be tough to communicate like you once did. But one of the challenges of Alzheimer’s, in addition to memory loss, is a difficulty in expressing ideas or in understanding those ideas, which is known as receptive communication, says Very Well Health.

Mindful listening, or active listening, is the act of truly listening to what the person has to say without speaking yourself, interrupting, or prodding the conversation along. It takes a long time to develop the skill of non-verbal communication and to become a good listener, but it is possible. While frustrating, there are some steps you can take to make conversations go more fluidly so you can communicate in a more effective manner. This includes knowing when to sit back and let your loved one talk. They have a lot to say…but sometimes they just struggle to find the right words. Let them get there on their own. When it’s time for your end of the conversation, heed these tips.

Tips For Communication

• Don’t talk down to them: It can be tempting to talk down to the person or treat them like they are an infant, called “infantilizing” or “elderspeak.” Essentially, this is how you would talk to a baby, with a high-pitched cooing voice that, while you don’t mean it to, can belittle the person you are speaking to. Use a respectful tone of voice that you would use for any other adult.
• Use their names: Use your loved one’s name or title (grandma, grandpa, etc.) and avoid using “sweetie” or “honey” which can be misconstrued as patronizing.
• Use gentle touch: Many Alzheimer’s patients crave personal touch, such as a hug or arm rub. Hold your loved one’s hand as you listen, which can provide comfort and reassurance as you navigate through your conversation.
• Don’t shout: Not everyone with Alzheimer’s has poor hearing. If you speak in a loud voice, they can take this as threatening behavior and may feel like you are angry at them. Start your conversation with a clear, normal tone of voice, and increase in slightly louder increments if they are having trouble understanding or hearing you. But always keep a non-threatening edge to your voice. If you get too loud, they may shut down.
• Speak directly to them: Look them in the eye and speak to them, rather than a nurse, caregiver, or companion who is standing nearby. Listen as they express their thoughts and needs. Give them the time they need to formulate their responses, and don’t interrupt unless they request it, says the Alzheimer’s Association.
• Get down to their level: It can be intimidating and domineering to stand directly above them and stare down. Get down to their level. Sit in a chair next to the bed, or sit down at the table with them. This physical closeness conveys a sense of equality, comfort, and respect. Speak slowly and clearly, giving them plenty of time to respond. You don’t want them to get a sense of impatience or frustration on your part, because they may get agitated.
• Don’t interrogate: While you’re actively listening, you may be building up a lot of questions in your mind to ask them. Let them finish their stories or thoughts before breaking in with any questions. When you do ask questions, don’t bombard them with several in a row. Space them out, if you have to, but your main goal for the visit should be to provide encouragement. When you do ask a question, make sure it’s not open-ended. It should elicit a simple answer in response to a simple choice, or a yes or no answer, such as “would you like coffee or tea?” or “are you warm or cold right now?”. Don’t ask what they want to drink or eat in an open-ended way, because this can be overwhelming.
• Make eye contact and smile: Smiling makes the person feel reassured rather than challenged. This is a way to show them that you are truly glad to be there. Look them in the eye when you’re listening to them so they know they have your full attention.
• Encourage nonverbal communication: Especially prevalent in the later stage of Alzheimer’s, many patients can’t find the words to tell you what they want. Encourage non-verbal communication if you are unsure what they’re trying to say. Ask them to point or gesture, using sights, touch, sounds, tastes and smells as a form of communication. You may get better results that way.

Contact Pathways Home Health and Hospice

We have a lot of experience and training with Alzheimer’s patients as part of our hospice program. To find out more about how we can help, contact us at 888-978-1306.