[This is Part 2 of a three-part series that explores dementia in people with intellectual and developmental disabilities. Part 1 focuses on how to recognize signs of dementia. Part 3 will explore how caregivers can respond to behavioral symptoms.]
When an individual with intellectual and developmental disabilities develops dementia, it’s important to reinforce the remaining communication abilities. Mental activity may help people keep some forms of dementia at bay. Below are techniques caregivers can use to facilitate daily communications:
- Relax. Before interacting with a person living with IDD and dementia, caregivers and family members should let go of their own emotions by using physical relaxation techniques like deep breathing. Doing relaxing deep breathing will help the caregiver interact with the individual—who may not make sense or may behave in an irrational way—without becoming anxious, annoyed, or frustrated.
- Be supportive and nonconfrontational. Use nonthreatening words to build trust and avoid being critical of the individual.
- Ask simple, concrete questions. Keeping conversation simple and direct will promote communication.
- Be patient. Allow plenty of time for responses. Talk slowly. Pause often. And repeat key phrases when speaking with an individual with IDD and dementia. His or her reaction times are likely much slower than before, pre-dementia.
- Rephrase and paraphrase. Repeat the individual’s basic message using the same key words, tone of voice, and speech cadence. This encourages continued communication not only by giving the person a chance to hear what they said but also by giving them time to gather their thoughts. This ensures the message conveyed is understood as intended.
- Reminisce. Encourage the person to explore and recall pleasant memories. Do not fixate on the accuracy of these memories. Simply encourage them to express themselves.
- Use pictures and objects to help you communicate ideas.
Create Memory Aids
To facilitate positive interactions and focus on maintaining learned information, albums or charts can be a great help. Caregivers can help individuals living with IDD and dementia create personal memory albums, which are small photo albums with easy-to-turn pages. Each page may contain photographs of a key memory on the left-hand page and a short statement about that memory on the right-hand page of a spread.
Another option is a personal memory chart, which may involve photos and statements placed on large, laminated pieces of cardboard posted on the person’s bedroom walls. Whether the person living with IDD and dementia is able to walk or spends most of the day in a wheelchair will dictate what height is best for posting the memory chart.
What should the memories focus on? The albums and charts can address:
- Facts that are important to the person.
- Information on conversation topics the person likes or wants to talk about. Ideally, caregivers identify three topics that are important to the person. They are topics from the person’s present life or from his or her past. Topics that the person often attempts to discuss can go here. Maybe he likes cats. Or she loves to tend plants and grow things. What does he care about? What does she love to do?
- Facts that the person often gets confused
The personal memory album or chart might also include:
- The person’s name, age, where they worked, things they like to do
- Names of family members and how they are related
- Elements of daily life: days and times for important events. Daily and weekly events, including meals, appointments, and family visits may be included here.
- Names of other people in the home or others in programs they attend
Although what the individual remembers may shrink, using these techniques and memory aids can help keep the person engaged and even entertained, spending time thinking and talking about what he or she likes most.
Talking About Dementia: A Guide for Families, Caregivers, and Adults with Intellectual Disability