Communicating with a person who has a neurocognitive disorder

As your loved one’s disease progresses, he or she will likely find it more and more difficult to express thoughts and follow a conversation. However, maintaining even limited communication can help to prevent certain challenging behaviours. Below are key strategies for communicating with a loved one who has a neurocognitive disorder (NCD). There are also practical tips on how to make conversations flow more easily.

Create a sense of trust and reassurance

A reassuring environment can make all the difference. The tone of your voice, the expression in your eyes, and caring gestures reflect your positive emotions and intentions toward your loved one. This is essential to maintaining a relationship of trust.

• Make direct eye contact to attract the person’s attention and show your interest.
• Use touch—a caress, kiss, handshake or even a massage—to show your affection and strengthen your relationship. However, if the person is agitated, touch may make things worse. Use your best judgment.

It's not them, it's the disease

Neurocognitive disorders can cause people to experience memory loss, impaired judgement, difficulty concentrating and communicating, increased or diminished physical sensitivity, and a loss of enthusiasm. By taking these elements into account, you’ll find it easier to interact with your loved one.

• Speak slowly and calmly, using simple words and short sentences. Give one instruction at a time, using gestures to make it easier for the person to understand.
• Be patient and don’t interrupt. Help the person complete his or her sentences. Avoid confrontation, even if their perception of reality seems confused. Try to distract the person or subtly change the topic of conversation.
• When talking about someone else, always mention the person’s name or nickname rather than saying “he” or “she.”

Try to understand what challenging behaviours mean

Challenging behaviours are a reflection of the changes occurring in the person’s brain, which make it increasingly difficult for them to communicate or follow a conversation. These behaviours are not an attempt to manipulate or be hostile. Rather, they are a translation of the person’s emotions, needs and attempts to adapt to the situation as best they can.

• Pay attention to behavioural cues; they can sometimes help you understand what your loved one is trying to communicate. This will help to prevent challenging behaviours and agitation.

Keep things consistent and predictable

By keeping your words and actions consistent, and maintaining a predictable environment, you can create a daily routine that is essential for a person who is gradually losing his or her ability to adapt to new situations.

• If you set the bar too high, your loved one will continually be confronted by challenges and failure. By lowering your expectations, you and your loved one will be able to spend more positive moments together.

Maintain your loved one's independence as long as possible

• Encourage the person to engage in daily activities that he or she is still capable of doing in order to maintain this independence for as long as possible.
• Choose activities that your loved one finds interesting or enjoyable. This will make him or her want to do things, be active and communicate with you. It is important to avoid activities that make your loved aware of his or her challenges or limitations.

There are workshops on how to better communicate with loved ones who are living with Alzheimer’s and other neurocognitive disorders. To find out which workshops are offered in your region, check our resource directory.

For more information, call Caregiver Support Helpline at 1 855 852-7784. Our professional counselors are on hand to listen, provide information and direct you to resources and services in your area.