Compassionate Communication with People living with Memory Loss

DON’T

• Don’t reason
• Don’t argue
• Don’t confront
• Don’t remind them they forgot
• Don’t question recent memory
• Don’t take it personally

DO

• Give short, 1-sentence explanations
• Allow plenty of time for comprehension, then triple it
• Repeat sentences or instructions exactly the same way
• Eliminate “but” from your vocabulary; substitute “nevertheless”
• Avoid insistence. Try again later
• Agree with them or distract them to a different subject or activity
• Accept blame when something is wrong (even if it is fantasy)
• Leave the room, if necessary, to avoid confrontations
• Respond to feelings rather than words
• Be patient, cheerful and reassuring. Go with the flow
• Practice 100% forgiveness.

REMEMBER

• You can’t control memory loss – you can control your reaction to it. Compassionate communication will significantly heighten quality of life.
• They are not crazy or lazy. They say and do things that seem normal to them.
• Don’t take accusations personally.
• Don’t ask too many questions that they may struggle to answer
• Open-ended questions that give them choices are difficult for them and can create anxiety. A simple choice between 2 items or directing their choice is better, e.g. “You look lovely in the red blouse, let’s choose that one”.
• People who are living with memory loss will be scared all the time. This may come out as becoming passive, unco-operative, hostile, angry, agitated or abusive. It may alternate between each state. The goal is to reduce anxiety as far as possible. Keep reassuring them, they may forget the reassurances you gave 5 minutes ago.

Try this…

DON’T REASON
Homeowner	“What doctor’s appointment? There’s nothing wrong with me.”
Sharer Don’t	Reason	“You’ve been seeing the doctor every 3 months for the last 2 years. It’s written on the calendar and I told you about it yesterday and this morning.”
Sharer Do	Explain simply	“It’s just a regular check-up” (repeat as necessary)
Sharer Do	Accept blame	“I’m sorry if I forgot to tell you”

DON’T ARGUE
Homeowner	“I didn’t write this cheque for £50. Someone at the bank is forging my signature”
Sharer Don’t	Argue	“What? Don’t be silly. The bank wouldn’t be forging your signature.”
Sharer Do	Respond to feelings	“That’s a scary thought.”
Sharer Do	Reassure	“I’ll make sure they don’t do that.”
Sharer Do	Distract	“Would you help me fold the towels?”

 

DON’T CONFRONT
Homeowner	“Nobody’s going to make decisions for me. You can go now … and don’t come back.”
Sharer Don’t	Confront	“I’m not going anywhere and you can’t remember enough to make your own decisions.”
Sharer Do	Respond to feelings	“I’m sorry this is a tough time.”
Sharer Do	Reassure	“We will find a way to manage it together.”
Sharer Do	Distract	“You know what?   There’s a postcard here from Peter…”

DON’T REMIND THEM THAT THEY FORGOT
Homeowner	“Peter hasn’t called for ages. I hope he’s OK.”
Sharer Don’t	Remind	“Peter called yesterday and you spoke to him for 15 minutes.”
Sharer Do	Reassure	“You really like talking to Peter, don’t you?”
Sharer Do	Distract	“Let’s phone him when we get back from our walk.”

DON’T QUESTION RECENT MEMORY
Homeowner	“I’m hungry. What’s for lunch? Will it be ready soon?”
Sharer Don’t	Question memory	“You had lunch an hour ago.”
Sharer Do	Explain simply	“It will be time for a snack at 4pm”.

DON’T TAKE IT PERSONALLY
Homeowner	“Who are you? Where is my daughter?”
Sharer Don’t	Take it personally	“What do you mean you want your daughter, not me?”
Sharer Do	Reassure	“”She’ll be here tomorrow…”
Sharer Do	Distract	“Why don’t we have a cup of tea and a biscuit?”

DO REPEAT EXACTLY
Homeowner	“I’m going out to buy a newspaper”
Sharer Don’t	Repeat differently	“If you’re going out you will need to put your shoes on. Please put your shoes on.”
Sharer Do	Repeat exactly	“Please put your shoes on.” “Please put your shoes on.”

DO ELIMINATE ‘BUT’ AND SUBSTITUTE ‘NEVERTHELESS’
Homeowner	“I’m not eating this.   I hate fish.”
Sharer Don’t	Say ‘but’	“I know that fish isn’t your favourite but it is very good for you.”
Sharer Do	Say ‘nevertheless’	“I know that fish isn’t your favourite (smile), nevertheless please try a little bit as it is so delicious”