Talk to patients slower than your normal speed
The speed of information processing decreases in patients with dementia. For this reason, we can reduce the burden on the patient's mind by reducing our speaking speed.
“In this way, the number of words and concepts that the patient needs to process in the mental process is reduced, and your dialogue can be more effective. Provide variable (multimodal) input. Many patients with dementia have primarily impaired verbal memory and their verbal input is difficult to memorize. Reinforcing these inputs with writing and accompaniment will make it easier to remember and learn. For example; While teaching a name, it should also be written, read, or associated with a picture.
Reduce the number of people speaking
Thus, the patient's existing confusion increases and the patient becomes agitated and As a result of his anxiety, the patient becomes withdrawn and prefers not to talk. For this reason, you should prefer to talk one-on-one with dementia patients or reduce the number of people speaking as much as possible.
Speak a little louder, without making your voice high-pitched.
The reason for this is the loss of perception of high-frequency sounds and the decrease in information processing speed. Speak as loudly as possible, slightly higher than your normal voice, without making your voice shrill.
Pay attention to your speaking tone and attitude
Although the ability of dementia patients to understand words and concepts is lost, be aware of the way you speak and your attitude. and they are aware of your tone. When talking to the patient, be careful not to raise your voice, speak explosively or too loudly, or use a threatening or commanding tone. In this way, your dialogue with the patient will be improved and you will avoid making the patient angry, disturbed, uneasy or angry.
Talk about the here and now
Talk to patients in the present, try not to talk about the future. Talk about things in the environment that patients can see or feel. In other words, the patient should be able to feel what is being said.
Sentence Content- While talking to the patient, Do not give more than one suggestion. Since the patient's mental information processing process is impaired, he will have difficulty understanding a second proposition. Since patients' immediate memory is impaired, they are likely to forget the first proposition when it comes to the proposition at the end of the sentence. For example, there are variable propositions in the following sentences:
1st proposition: My stomach hurts,
2nd proposition: When I woke up in the morning, my stomach hurt,
3rd proposition: In the evening When I woke up in the morning, I had a stomach ache because of the food I ate.
Thus, sentences similar to the sentence in the 1st proposition should be made, long sentences containing many propositions as in the 2nd and 3rd proposition should be avoided, if necessary, the sentences should be divided and after understanding the 1st sentence, the 2nd sentence should be made. sentence should be passed. Review unclear sentences and make them understandable.
Talking during the activity increases intelligibility
Many studies have found that talking to the patient during the activity increases intelligibility. Arranging flowers, building something, sewing and painting activities allow patients to produce speech based on immediate things.
Use simple words
Simple and frequently used words will be easier to understand. Therefore, it is more efficient to convey information using frequently used words. Sentence a and b may mean the same thing, and sentence b is easier to understand. Review unclear words and use understandable words. (A: Harmonica is heirloom, B: Mouth harmonica is very durable)
Use real nouns instead of pronouns
Replace nouns in the sentence. Avoid using pronouns. For example, use the person's name instead of 'he'. Because when a pronoun is used, it must be remembered with the name it replaces. This task places additional burden on the patient's memory and makes understanding difficult. It is necessary to use the 2nd sentence as in the example below. (1st sentence: Ayşe and Mehmet dropped Hasan off at school. They didn't want him to be late for class. 2nd sentence Ayşe and Mehmet dropped Hasan off at school. They didn't want Hasan to stay to class.
Multiple choice word Do not use 's
Patients have difficulty answering open-ended questions that require free recall, such as 'What did you eat last night?' or 'What would you like to eat?' Patients should avoid asking open-ended questions that require free recall, such as 'Do you want meat or chicken?' etc. You should ask multiple choice questions.
Do not treat the patient like a child
Due to the deterioration in their brain structures, patients with dementia cannot understand what is done in their daily functions and the slowdown in their perception makes them feel like a child. makes you vulnerable. Treating the patient like a child due to problems in the learning process may sometimes be perceived as sarcastic by the patient and may make the patient uneasy. At the same time, sarcastic attitudes and unnecessary jokes to the patient should be avoided. Because of patients' inability to abstract and perceive concepts, jokes may exceed mental capacity. For these reasons, treating the patient like a child will make him/her feel helpless and may cause him/her to become uneasy.
Avoid placing patients in a free-remembering environment
When visitors come, it would be more accurate to say 'Ahmet and Zeynep came to visit' instead of saying 'look, the guest has arrived'. This way, the patient will not feel distressed because he does not remember.
Avoid changing places frequently
Dementia patients have problems processing new information. Therefore, avoid changing situations that have already been learned. As the place where patients live and the location of their belongings change, the patient has difficulty in adapting to the new place and the location of the objects, has difficulty in learning the new place, and for these reasons, confusion increases. For this reason, relocation of patients should be avoided; if relocation is unavoidable, the interior design of the new room should be similar to the old room, and the same items should be placed in similar or visible places (glasses, shoes, combs, etc.).
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Stop constantly editing the patient's mistakes
Dementia patients often make incorrect sentences, and caregivers point out their mistakes, especially He corrects himself very often in front of other people. Once the patient becomes self-defense, irritability, discomfort, restlessness or exuberance develops and he/she loses the desire to talk.
Organize the patient's living space
The purpose of environmental changes is to create a safe and peaceful environment that makes life easier. Place a night light in the patient's bedroom and bathroom. Put a security gate in the stairwell. Remove or secure carpets if possible. Install fixed furniture or grab bars on the walkway that can provide support during instability. Hide electrical cords to prevent tripping. Lock doors to prevent the patient from walking away; However, be sure that the patient can escape in the event of a fire. Place a fixed light source with a remote control at the head of the patient's bed. Place non-slip bath towels in the bathroom and shower areas. Put an identification bracelet on the patient's arm stating his/her name, surname and memory impairment.
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