Effectively Communicating with Dementia Patients about Treatment Options

After patients receive a dementia diagnosis, it is important for healthcare providers to communicate with them about treatment options in an effective manner. Whether discussing drugs like Aducanumab for Alzheimer’s disease, medications for memory, cognition, and dementia-related behaviors, therapies, or implementing lifestyle changes, there are several best practices for effective and constructive communication.

It is important to understand that dementia is a complex disease that affects each individual differently. While communication is inherently different when interacting with an individual experiencing the early stages of dementia versus the later stages of dementia, it is essential to make no assumptions regarding an individual’s ability to communicate based on the stage of the disease. Communication with two dementia patients who are in the same stage of the disease might look totally different. 

Let’s take a look into potential behaviors to anticipate when communicating with dementia patients and tips for communicating with dementia patients about treatment options and brain health monitoring tools.

What to Expect When Communicating with Dementia Patients 

Communicating with someone who has Alzheimer’s disease or another form of dementia can be challenging. Individuals with dementia, depending on the severity, may have difficulty understanding others and may struggle to communicate what they are trying to say. Patients often exhibit noticeable patterns in conversation, including:

• Losing their train of thought.
• Repeating words or questions.
• Having difficulty finding the right word.
• Substituting words.
• Speaking less frequently.
• Describing objects rather than naming them.

Best Practices for Communicating with Dementia Patients About Treatment Options

Effectively communicating with dementia patients about treatment options relies heavily on having patience, listening skills, and utilizing different strategies for different individuals. While interaction with dementia patients may vary significantly from patient to patient, there are a number of tips and strategies to alleviate common challenges. Detailed below are some of the top tips for healthy communication.

• Keep it simple: Use short and clear sentences when discussing treatment and therapy options. Speak clearly and ask one question at a time. This is particularly important for individuals in the later stages of dementia.
• Be patient and bring a comforting presence: Receiving a dementia diagnosis and discussing treatments can be daunting and frightening for patients. If they are having trouble communicating, offer them comfort and encouragement, allowing them to take their time when speaking and responding. Listen carefully and allow them to speak without interruption.
• Remove distractions: Prepare the room in which you will be discussing treatment options. Eliminating background noise and visual distractions can make it easier for patients to hear you and concentrate on the conversation.
• Check for understanding: Be aware of how the patient is reacting to each treatment or therapy option. What does the tone of their voice convey? What do their facial expressions and body language indicate?
• Speak directly to the patient: Even if the patient’s family member, companion, caregiver, or support system is present, speak directly to the patient and maintain eye contact to make it clear to the patient that their thoughts and opinions are heard and valued.

Discussing Monitoring Brain Health Throughout Treatment

After communicating with dementia patients about treatment options, it is a good time to discuss how the patient would like to monitor their brain health throughout the course of their treatment. Traditional options include pencil and paper memory tests, such as the following:

• Mini-Mental State Exam (MMSE): Rated on a 30-point scale, the MMSE is often used as a screening tool as well as a means to monitor the progression of neurocognitive diseases. This assessment asks the patient to answer a series of questions, including stating the current date, counting backward, and identifying everyday objects.
• The Montreal Cognitive Assessment (MoCA): The MoCA is rated on a 30-point scale and involves similar elements to the MMSE while incorporating a Clock Drawing Test (CDT) and Trail Making Test.
• The Mini-Cog: The Mini-Cog is typically used as a quick screening tool and is rated on a five-point scale. The Mini-Cog consists of the following three steps: 

1. The patient is asked to remember three words.
2. The patient completes the CDT.
3. The patient must then recall and state the three words from before the CDT. 

The above methods for monitoring brain health require administration by a doctor, clinician, or other healthcare professional and often take a significant amount of time due to the clinical waiting time as well as the analysis and reporting time. Such methods also lack the ecological validity to assess brain health as it relates to the patient’s ability to complete normal day-to-day activities and may not provide a robust measure of the efficacy of treatments or therapies.

Other options for monitoring brain health include digitized versions of the above memory tests as well as digital medical devices, such as one that is currently in development by Altoida.