Person-Centered Communication in Dementia Care
Person-centered care, pioneered by Tom Kitwood in the 1990s, emphasizes recognizing and supporting personhood despite cognitive decline. This approach forms the foundation for effective communication in dementia care.
Principles of Person-Centered Communication
Person-centered communication in dementia care is guided by several core principles:
Recognition of Personhood
Person-centered communication acknowledges that individuals with dementia maintain their personhood—their fundamental humanity, identity, and dignity—despite cognitive changes. This recognition influences how we approach, address, and interact with the person (Savundranayagam et al. 143).
Respect for Individual Identity
Each person with dementia has a unique life history, preferences, values, and cultural background that shape their communication style and needs. Person-centered communication respects this individuality and adapts accordingly (Kontos et al. 1004).
Focus on Abilities Rather Than Deficits
Person-centered communication emphasizes what the person can still do rather than what they cannot. This strength-based approach helps maintain dignity and self-esteem (Savundranayagam et al. 144).
Validation of Emotions and Experiences
Even when a person with dementia expresses perceptions that seem inconsistent with reality, person-centered communication validates the emotional truth of their experience rather than contradicting or correcting them (Vasse et al. 892).
Promotion of Agency and Choice
Person-centered communication supports the person’s autonomy by providing opportunities for choice and decision-making, even if these are simplified to match cognitive abilities (Savundranayagam et al. 144).
Person-Centered Communication in Practice
Implementing person-centered communication involves specific practices:
Knowing the Person’s History and Preferences
A fundamental aspect of person-centered communication is knowing the person—their life history, career, family relationships, hobbies, preferences, and important life events. This biographical knowledge allows for more meaningful interactions and provides context for interpreting communication attempts (Savundranayagam et al. 145).
Practice strategies include:
- Creating and using biographical profiles or “life story books”
- Consulting family members about communication preferences
- Observing what topics or activities elicit positive responses
- Maintaining consistency in care providers when possible
- Taking time to learn about cultural factors that influence communication
Addressing the Person Appropriately
How we address the person sets the tone for the interaction and reflects our recognition of their dignity:
- Use the name they prefer (which may be formal or informal)
- Avoid infantilizing terms like “sweetie” or “dear” unless you know they prefer them
- Introduce yourself each time if they may not remember you
- Position yourself at eye level and establish eye contact when culturally appropriate
- Address the person directly, even if a family member or interpreter is present
Creating a Supportive Environment for Communication
The physical and social environment significantly impacts communication success:
- Reduce background noise (turn off TV/radio during important conversations)
- Ensure adequate, non-glare lighting
- Minimize distractions during conversations
- Create a calm, unhurried atmosphere
- Ensure privacy for sensitive discussions
- Consider the time of day (respect optimal times when the person is most alert)
Adapting to Changing Abilities
Person-centered communication adapts as the person’s abilities change:
- Regularly reassess communication abilities and preferences
- Adjust expectations and approaches as needed
- Recognize that abilities may fluctuate day to day or even hour to hour
- Be prepared to shift between verbal and nonverbal approaches
- Document successful strategies to share with the care team
Research shows that person-centered communication is associated with reduced agitation, improved mood, and greater engagement in people with dementia. For care providers, it is linked to increased job satisfaction, reduced burnout, and improved care relationships (Savundranayagam et al. 146).