Special Communication Considerations

Certain factors require special consideration when communicating with people who have dementia.

Communicating with People with Sensory Impairments and Dementia

When dementia is accompanied by sensory impairments, communication becomes more complex:

Visual Impairment and Dementia

For people with both visual impairment and dementia:

• Identify yourself clearly upon entering their space
• Explain environmental changes or movements
• Use touch to alert the person before speaking
• Provide detailed verbal descriptions
• Place items consistently and describe locations
• Use tactile cues and textured surfaces
• Ensure adequate, non-glare lighting
• Use contrasting colors for important objects
• Be aware that visual hallucinations may be more common

Hearing Impairment and Dementia

For people with both hearing impairment and dementia:

• Ensure hearing aids are functional if used
• Reduce background noise
• Position yourself on the better-hearing side if applicable
• Face the person directly for lip-reading cues
• Speak clearly without shouting
• Lower the pitch of your voice
• Use visual cues to supplement speech
• Watch for signs of misunderstanding
• Be aware that hearing loss may exacerbate paranoia or suspicion

Combined Sensory Impairments

For people with multiple sensory impairments:

• Utilize the remaining sensory channels effectively
• Use tactile communication consistently
• Establish touch cues for common interactions
• Create environmental modifications that support remaining senses
• Be consistent with routines and approaches
• Allow extra processing time

Small et al. note that unaddressed sensory impairments can exacerbate cognitive difficulties and may be misinterpreted as cognitive decline. Their research indicates that proper sensory interventions combined with adapted communication techniques can improve functional communication by up to 40% in people with combined sensory and cognitive impairments (Small et al. 772).

Cultural Considerations in Dementia Communication

Cultural background significantly influences communication patterns and preferences:

Cultural Variations in Communication

Cultural factors that influence communication include:

• Directness vs. indirectness
• Formality and terms of address
• Eye contact norms
• Personal space preferences
• Touch acceptability
• Decision-making processes
• Expression of pain or distress
• Discussion of certain topics (e.g., bodily functions)
• Use of silence
• Gestures and their meanings

Language Considerations

For people from culturally and linguistically diverse backgrounds:

• Determine the preferred language
• Use professional interpreters rather than family when possible
• Speak directly to the person even when using an interpreter
• Be aware that bilingual individuals may revert to their first language
• Learn key phrases in the person’s primary language
• Use visual cues to transcend language barriers
• Be aware of cultural idioms and metaphors that may not translate directly

Culturally Responsive Communication

Developing culturally responsive communication involves:

• Learning about the specific cultural background
• Consulting family members about communication preferences
• Adapting approaches based on cultural norms
• Respecting cultural communication patterns
• Being aware of potential cultural misunderstandings
• Avoiding stereotyping while acknowledging cultural patterns
• Documenting effective culturally specific approaches

Research by Kontos et al. emphasizes the importance of cultural habitus—deeply ingrained cultural dispositions and practices—in dementia care. Their work demonstrates that culturally familiar communication patterns often remain accessible even in advanced dementia (Kontos et al. 1010).

Technology-Assisted Communication

Various technologies can support communication with people who have dementia:

Low-Tech Communication Aids

Simple tools that can enhance communication include:

• Communication boards with pictures and words
• Memory books and photo albums with labels
• Personalized memory wallets
• Simplified written instructions
• Pictorial schedules
• Memory aids such as clocks and calendars with clear displays
• Voice amplifiers for those with hearing impairment

Digital Communication Supports

More advanced technological supports include:

• Tablet applications designed for people with dementia
• Digital photo frames with recorded messages
• Simplified mobile phones or telecommunication devices
• Voice output devices for those with speech impairments
• GPS systems for safety that also support communication about location
• Sensory stimulation systems that encourage response and interaction
• Telehealth platforms adapted for cognitive impairment

A study cited by Burgio et al. found that personalized tablet-based communication applications improved interaction quality in 85% of participants with moderate dementia, with particular effectiveness for those with expressive language difficulties (Burgio et al. 153).