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Communication Changes As Dementia Progresses Cheat Sheet (DRAFT) by [deleted]

This is a draft cheat sheet. It is a work in progress and is not finished yet.


Arming caregivers with knowledge about the progre­ssion of dementia helps in the creation of an indivi­dua­lized care plan. In addition, person­-ce­ntered dementia care is better served when caregivers are able to recognize behaviors and commun­ication issues that are common through the three stages of dementia.

Early Stage (Mild)

■ Cannot find the right words to name things or to complete thoughts;
■ Scrambles sequence of events when relating a story;
■ Speaks of past events as if they are currently taking place;
■ Cannot remember what was just said;
■ Has difficulty following direct­ions;
■ Short-term memory is affected, may repeat questions and stories;
■ Makes multiple phone calls to a family member to ask about appoin­tments, people, and places;
■ Becomes suspicious and makes paranoid or accusatory statem­ents; and
■ Becomes defensive if corrected or if his “reality” is challe­nged.

Middle Stage (Moderate)

■ Confused if someone talks fast or uses slang, or if someone uses abstract ideas or offers too many thoughts or choices;
■ Needs more time to respond to others or to join conver­sat­ions;
■ Becomes frustrated if more than one person talks at the same time;
■ Begins to use substitute words or uses unorga­nized sentences;
■ Is often reduced to yes/no responses out of fear of making mistakes “in public;”
■ Makes inappr­opr­iate, odd, or impolite statements (dementia erases lines not crossed in “polite company”);
■ Repeats questions and stories;
■ Sings frequently or speaks in rhyme; and
■ Is prone to fabricate forgotten details.

Steps for Successful Commun­ication

Late Stage (Severe)

■ Speaks one to six words a day;
■ Uses words that make no sense, or may just be sounds;
■ Repeats what’s been said rather than responding to speaker;
■ Responds to nonverbal commun­ica­tion: music, sound, touch, and visual stimul­ation; and
■ Commun­icates needs nonver­bally through behaviors, facial expres­sion, and sounds.