Effectively Communicating with Dementia Patients about Treatment Options

After an individual receives a dementia diagnosis, it is important for healthcare providers to effectively communicate treatment options. Whether discussing drugs like lecanemab 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 individuals 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 people living with dementia 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 cause of dementia can be challenging. Individuals living with dementia, depending on the severity, may have difficulty understanding others and may struggle to communicate what they are trying to say. People living with dementia 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 involves having patience, listening skills, and utilizing different strategies for different individuals. While interaction with dementia patients may vary significantly from person to person, 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. 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 them to hear you and concentrate on the conversation.
• Check for understanding: Be aware of how they are 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 them: Even if the individual’s family member, companion, caregiver, or support system is present, speak directly to them and maintain eye contact to make it clear 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 they 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 individual 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 individual is asked to remember three words.
2. The individual completes the CDT.
3. The individual 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 individual’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 digitized cognitive assessments, such as one that is currently in development by Altoida.