Communication Strategies When Working With Confused Persons/Patients
General Attitude and Approach
 | Stay calm |
| Be flexible |
| Be non-resistive |
| Be guiding, not controlling |
Verbal Approaches
| Use concrete, exact, positive phrases; repeat the same phrase. |
| Trigger automatic responses. |
| Break tasks down into single task instructions like "walk forward", "stop", "turn around", and "sit down". |
| Make a suggestion if the person is unable to make a choice. |
| Use a calm, slow, soft voice pattern. |
| Ask one question at a time and wait for a response. |
| Do not argue or try to reason. |
| Use distraction. |
| Keep your promises, so promise only what you will be able to do. |
| Include the person in your conversation. |
| Identify the person's vocabulary and use it - if he likes the word "potty" for bathroom, then the staff should use that word. |
| Treat the person as an elder or a peer, not as a child. |
| Acknowledge the person's feelings and help her name it if she has difficulty, for example: "You look sad. Do you miss your daughter after she leaves?" |
| Give directions within attention span. |
Non-verbal Approaches
| Practice "looking friendly" - your attitude/mood is contagious, felt by all, even if you share it verbally only with the other staff. |
| Make your verbal and non-verbal messages the same. |
| Stand in front and make eye contact. |
| Assume and equal or lower position, especially if the person feels powerless. |
| Move slowly. |
| Approach from the front, not the side or behind. |
| Avoid overwhelming the person physically or verbally (approaching an anxious person with three or more people may lead to a catastrophic reaction). |
| Use lots of touch, if the person enjoys it. Allow time for the person to touch you. |
| Identify symbolic behaviors and their meaning - the cup the person wishes to hang onto after meals may be symbolic for having coffee with friends and relatives and be a source of security and comfort. |
Twelve Basics For Alzheimer's Care
| Alzheimer's is a disease, not a normal part of aging. |
| Accept the disease. Persons are not "misbehaving" or forgetting on purpose. You can not change this reality, but you can manage the behavior. |
| Arguments are useless; in fact, they make matters worse. Confusion, memory loss and frustration are making the person behave irrationally and you can't "argue" them out of it. |
| Allow as much freedom and independence as possible while keeping safety and comfort in mind. |
| Actions help when verbal communication may fail. Help the person by demonstrating what you mean, or sometimes, start them in the activity. |
| Assume that the person may hear and understand what you say even if they are confused. Do not say things to others in front of them as if they are deaf. |
| Appreciate good moments or good days, even though the person's ability is not going to remain that way. |
| Appropriate activities which help persons pass the time meaningfully and productively and reduce agitation, boredom, daytime sleeping, and depression. |
| Agitation can be alleviated when the caregiver remains calm, reassuring and respectful of the person's feelings. |
| Adults with disabilities are still adults. Mental level is not always equal to social level. |
| Adapt the task to fit the ability of the person. Break down the activity into separate steps, or simplify task by eliminating parts that could be frustrating. |
| Assessment is ongoing. What is safe and effective for now may not be so at a later time. Keep watching and reevaluating. |