Keep it Simple, Smile (KISS)

By Carol Combs, MSW, Oxford’s Memory Care Program Coordinator

As humans, we are communicating from the time we are born. Alzheimer’s disease and related dementias can gradually diminish the ability to communicate as the disease progresses. That person’s ability to express thoughts and comprehend what others are saying can be affected. Individuals with Alzheimer’s or dementia may forget words, invent words or use familiar words repeatedly. They may lose their train of thought and become frustrated at not being able to express themselves.

Communicating with memory-impaired individuals presents challenges, but there are some techniques that you can learn to ease understanding.

  1. KISS (Keep it Simple, Smile)A smile can communicate when words cannot. A person with Alzheimer’s or dementia understands a smile and the feeling behind it. Social skills remain intact when language fails so a handshake, greeting, pat on the back or holding hands are ways to communicate without a lot of words. Touch is the most basic form of human connection.
  2. Speak Slowly and ClearlyIt takes much longer for a person with dementia to process what has been said. Use short, simple sentences and maintain eye contact. Give them time to respond. If they do not understand, repeat with the same tone and facial expression and change key words if necessary.
  3. Tone of VoiceAs a caregiver, it is sometimes common to revert to a parental role, which can come across as condescending and disrespectful. Communicate in a pleasant, patient and unhurried manner. People with Alzheimer’s or dementia are aware of nonverbal cues such as facial expression, stance, tension or mood and may react similarly. If you are impatient, anxious, or frustrated, they are likely to become annoyed or agitated.
  4. Use One Step DirectionsBreak down tasks and instructions into clear, simple steps. Do the activity with them such as brushing teeth so they can mimic the task.
  5. Offer Praise and EncouragementFor the person who is gradually losing the ability to perform basic activities, it is important to maintain feelings of success and self-esteem. Use phrases like “You’re doing fine”, “Good job”, “You look very nice”, and ‘’Thank you”.
  6. RephraseAvoid vague words – Instead of “Here it is”, try “Here’s your hat”.
    Turn a negative into a positive – Instead of “Don’t go there” try “Let’s go here”.
    Provide the solution rather than the question – Instead of “Do you need to use the bathroom?” try “The bathroom is right here”.
    Avoid open-ended questions – Instead of “How many children do you have?” try “What was it like to raise 5 boys?”
    Ask yes/no questions – Instead or “How do you feel?” try “Are you tired?”
    Limit choices – Instead of “What do you want for lunch?” try “Would you like chicken or fish?”

Most importantly, treat them with dignity and respect, regardless of how difficult communication becomes. The person with Alzheimer’s or dementia can understand nonverbal communication and humor longer that they can understand spoken communication. Even when the person is unable to communicate, they need affection, which you can communicate through touch.

If you have questions or concerns our Memory Care Program Coordinator would be glad to assist you.  Additional information is also available through the Alzheimer’s Association.