A person diagnosed with Frontotemporal Dementia (FTD) may experience changes in their ability to communicate. This is challenging for both the person living with FTD and care-partners when methods of communication that have been effective for years, or even decades, are no longer fruitful. Below are five communication strategies to try if you are having difficulty connecting with someone with FTD. It may take some trial-and-error to find which strategies work best for your circumstances. If you are continuing to struggle with communication, do not hesitate to reach out to your care team for additional support.
1.Avoid Reasoning
In most conversations, we reason with others to get them to understand our point or follow our directions. When communicating with individuals with FTD, this may be more difficult. Someone with FTD may not be able to comprehend the reasoning behind your request or understand why a behavior or statement is upsetting. Explaining the logic behind your question or argument may no longer make sense to the person with dementia. Likely, efforts to get someone with FTD to understand why they are wrong will result in more agitation for both parties.
Rather than reason, try focusing on the emotion behind what the person is saying. For example, if the person is fixated on the belief that they should be able to drive, despite failing their driver’s evaluation, you can express empathy for their loss of independence. Rather than say, “Of course you can’t drive, you failed your exam!” You might try, “I know it must feel so frustrating that you can no longer drive. I hear you saying how upsetting this is. Can I take you to get your favorite ice cream?” By providing an empathetic response and subsequently a distraction, you can avoid the tailspin of reasoning, while also showing the person with FTD that you hear their concerns.
Similarly, you may provide that same grace to yourself as a care-partner. If your loved one with FTD says something hurtful, you may calmly tell them you are feeling sad while quietly reminding yourself it is “their disease talking.” After making your initial statement, you may move on with a positive distraction or take a self-care break, rather than trying to get your loved one to understand why their behavior was wrong.
2.Simplify Your Communication
When communicating with someone with FTD, opt for shorter sentences. This may aid the person’s comprehension and prevent confusion. For example, you may have previously introduced an evening’s plans to your spouse by saying, “We are going to our son’s hockey game later in Pittsburgh. Shelley is going to pick us up. Don’t you think you should put gloves on? Also, where do you want to stop for dinner on the way?” This explanation includes a lot of information that may be overwhelming to the person with FTD.
Instead try, “We are going to our son, Billy’s, hockey game in Pittsburgh. [pause]. Where would you like to stop for dinner?” Once that question is answered, you may provide your loved one the gloves they need for the game. Before you leave, you may inform them that your sister, Shelley, will be picking you up in five minutes.
If your loved one is having difficultly comprehending, you may provide more follow-up information. If they ask why they need gloves, you might say “We are going to a hockey game. This is on an ice rink where it is cold.”
Finally, minimize distractions. Turn off any background noise from the TV, radio, etc. and look directly at the person with FTD when you are speaking to them.
3.Maximize body language
If you are struggling to communicate with your loved one, or notice they are getting agitated when you ask what you perceive to be simple questions, reexamine your body language and tone. Even if your question is non-threatening, if your tone or body language are closed off, your loved one may notice these signals and respond with agitation. In general, try to keep body language open and relaxed. If you are entering a room where your loved one is, announce your entrance with a calm voice. When possible, avoid raising your voice and keep a positive inflection throughout conversation.
4.Get Creative
When old ways of communicating are no longer effective, it may be time to get creative. If your loved one struggles with speech and comprehension, you may label household items with their names and photos. Additionally, it can be helpful to keep a photobook handy that you can utilize when your loved one is having difficulty coming up with a word or name.
You may also employ the help of a speech therapist to assist with strategies for conversation and communication.
5.Take a break
If you have tried all the tools in your toolbox and are still unable to get your message through to your loved one, take a break! Pushing the issue will likely only continue to frustrate both of you. If possible, calmly walk out of the room and return to the question when you both have had some time to decompress. You may try asking the person your question in a different setting, or with different language. If you feel you have exhausted your efforts, consider calling in a trusted friend or family member to ask your loved one to complete the desired request.
These strategies are a starting point for more effectively communicating with your loved one with FTD. It is important to remember that their disease is impacting their ability to communicate, and they are not being intentionally obstinate or difficult. This is a challenging part of the disease, and it is important to give yourself grace, take breaks, and reach out to your support system to ensure you are being taken care of as well.
~ Kate Lietz, MSW, LSW, Social Worker