Communicating with Individuals with Cognitive Impairments: Understanding Mental Health and Memory Challenges Leave a comment

In caregiving, it’s important to understand how to communicate effectively with individuals with cognitive impairments. These impairments can affect mental health and memory, making communication more challenging. In this section of our guide on Fundamentals of Caregiving, we’ll explore strategies for communicating with individuals facing these challenges. By understanding their unique needs and adapting our communication approach, we can provide better support and care for those we serve.

Mental Health Impairment

A person with an emotional or behavioral health issue may have distorted thinking. They may hear voices, see things that aren’t there, be paranoid, or have difficulty communicating. Usually, this does not mean the person is aggressive unless they feel threatened. Here are some communication guidelines to use:

• If the person has difficulty conversing with you, they may be able to enjoy your company in other ways. Consider watching television, listening to music, playing cards or being read to. Talk about childhood events.
• Allow the person to have personal space in the room. Don’t stand over them or get too close. This includes touching the person. If you try a soothing touch, the person may hit you.
• Don’t block the doorway; avoid continuous eye contact
• Try to remain calm with a soothing approach. Speak with a slow-paced and low-toned voice
• Use short, simple sentences to avoid confusion. If necessary, repeat statements and questions using the same words
• Establish a structured and regular daily routine. Be predictable. Be consistent. Do not say you will do something and then change your mind
• Offer praise continually, ignore the negative and praise the positive
• Avoid over-stimulation, try to reduce stress and tension 
• Respect their feelings. Saying, “Don’t be silly; there’s nothing to be afraid of”, will get you nowhere. Let the person feel frightened by saying, “It’s all right if you feel afraid. Just sit here by me for a while.”

Memory Impairment

A person with cognitive or memory impairment has difficulty thinking and remembering. They can become very embarrassed if you ask them names or dates. Since their long-term memory is much more intact, they may dwell on events in the past and not remember such things as a relative’s death or that a child has grown up. The two most important factors when working with individuals with cognitive impairments are your actions and your reactions to the individual and their behavior. 

Here are some guidelines to follow when communicating with individuals with cognitive or memory impairment:

• Use a calm voice and be reassuring. The person is trying to make sense of the environment. Redirect and give honest compliments. 
• Do not argue with the person. If the person tells you they are waiting for someone to come, and you know that that person died several years ago, do not state, “You know such and such died several years ago.” The person may get mad because they feel you are wrong or become grief-stricken because they have just learned the person died. It would be better to reassure the person that everything is all right; the person has just been delayed. Then divert their attention to another activity. 
• Treat each person with talents and abilities deserving of respect and dignity. Individuals can usually tell if they are being talked down to like a child, which can worsen the situation.

In conclusion, understanding how to communicate effectively with individuals facing cognitive impairments is crucial in caregiving. Mental health impairments can distort thinking and perception, requiring caregivers to approach communication with patience and sensitivity. By providing a calm and reassuring presence, respecting personal space, and using simple language, caregivers can help individuals feel more at ease. Similarly, memory impairments can pose challenges, but by avoiding arguments, providing redirection, and treating each person with respect, caregivers can create a supportive environment where everyone feels valued and understood.