Communicating with Residents in Late Stage Alzheimer’s Disease

Over 40% of assisted living residents have some form of Alzheimer’s disease (AD) or other dementia.  When a resident reaches late stage AD, communication can become particularly challenging. The resident may no longer be able to express his/her needs or let you know when he/she is in pain.  In very late stages, communication may even be limited to grunts, groans, crying, laughing, or facial expressions.

In Coach Broyle’s Playbook for Alzheimer’s Caregivers from the Alzheimer’s Association, they suggest these tips for communicating with residents in late stage AD:

  1. Continue to talk to the resident; we may not know what he/she can understand.  Never assume the resident cannot hear or understand you.
  2. Express caring and affection by singing, touching, hugging, or holding the resident’s hand.
  3. Create a positive environment through music, reminiscing, and other psychosocial activities.
  4. Watch for nonverbal cues, such as moaning, crying, or grimacing.  These could be signs of pain or other unmet needs.
  5. Follow a sound plan of care.  Plan for needs that the resident may not be able to express, such as toileting, eating, ambulating, etc.
  6. Monitor proper food and fluid intake.  The resident could quickly become dehydrated or undernourished.

Take a look at our line of dementia care staff training DVDs for more information.

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