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How do you talk to someone with Alzheimer's?

Communication techniques found in validation therapy and reminiscence therapy can be used to talk to someone with Alzheimer’s. The validation approach is efficient for mood-based cases, while the reminiscence approach is utilized to foster cognitive functions.

In this article, I am going to explain both approaches. In addition, you will learn how to use them in various scenarios. Here is a broad overview of the topics:

Table of Content
Validation Therapy
Communication techniques
Example scenario
Reminiscence therapy
Communication techniques
Example Scenario
A word from the author
List of Resources
About the Author

Validation Therapy

The validation therapy is part of the emotion-oriented Alzheimer’s treatment, though, it can not cure Alzheimer’s. It can be used to create an atmosphere of comfort and safety for someone with Alzheimer’s.

Special communication techniques are utilized by caregivers and family members to take better care of the patient.

The aim of validation therapy is to make someone with Alzheimer’s feel understood and comfortable.

Being understood and feeling a sense of comfort/safety helps reduce tension, which is mostly created by a mood shift.

It is key to not question the behavior and mood changes.

When using this approach one accepts that the disease causes the behavior. Not the patient. The Alzheimer’s patient is not responsible for his behavior and mood.

It goes without saying, any judgments should be left aside.

Before we continue with the communication techniques, I would like to ensure that you understood the mandatory mindset.

Key Mindset required before using this approach
6 key mindsets
Not judging the individual's behavior
Making the patient feel understood
Creating an atmosphere of comfort
Coming up with solutions that reduce tension
Accepting mood changes as a result of the disease
Believing in the competence of the patient

Communication techniques

Using only supportive phrases to achieve a comfortable environment. Such phrases that can be used and adapted are:

Supportive phrases
6 Examples
“I understand what you say, then should we ….”
“I hear what you say, let’s try to …”
“I agree with what you are saying, how about …”
“Indeed that is …, and also …”
“I follow your thought, let’s do it as you say.”
“I support your idea, do you want to do it now?”

The structure is simple. Always start with a statement of encouragement. Then, a solution can be proposed.

Quit on all negative words when using the validation therapy with an Alzheimer’s patient.

For example, but, don’t, can’t, shouldn't disagree, should be avoided at all cost.

Example scenario

Let’s say a family member diagnosed with Alzheimer’s dementia searches for his wallet. He can not remember where he placed it.

Suddenly, a change in mood “kicks in” and he becomes hostile. He starts yelling: “Somebody stole my wallet!”

By using the validation approach one could reply: “I hear what you say, how about we search together for it before we call the police?”

He might answer back: “Oh, you don’t believe me, anyway!”

At this point, one should stay calm and reply: “I believe you, your wallet is stolen. Let’s first search together, before I call the police for you.”

At this point, the Alzheimer’s patient becomes a bit calmer.

If not then follow this rule: Do not leave the room. The patient might feel discomfort once being left alone.

Remember: The aim of validation therapy is to create an atmosphere of comfort for someone with Alzheimer’s.

Another important rule: Stay positive. Or in slang: “Keep up the good vibes!”

I know, sometimes it sounds better said than done. But just one negative word can make the entire work obsolete.

As you can see, mindset is important.

Do not question the behavior. Do not question whether the wallet is stolen.

The priority is on the patient’s feelings. Let them feel safe.

How would you feel, if your wallet is stolen? Probably not that well either.

So, try to show real empathy.

Reminiscence therapy

This is another type of emotion-oriented treatment. And just like the previous therapy, it can not cure Alzheimer’s. If you know Latin then you might realize: “reminiscor” means “I remember”.

Thus, reminiscence derives from reminiscor. Therefore, the definition makes sense:

Reminiscence therapy encourages Alzheimer’s patients to talk about their past.

The overall objective is to improve the individual’s mental abilities.

For example, cognitive functions like to remember or think. And of course, to improve one’s quality of life.

The approach also helps to increase a patient’s self-respect.

It makes him feel valued.

Somebody is listening to what he has to say.

Thus, feeling less like a burden and more like a part of society.

Communication techniques

In this approach, one is mostly using “opening questions''. Such questions provoke storytelling answers.

Opening questions that can be used and adapted include:

Opening phrases
6 Examples
“How was your childhood?”
“What was working back then like?”
“How did you meet your wife?”
“How was school?”
“What do you appreciate the most from the past?”
“What are you most proud about?”

The structure is pretty straightforward.

Ask only questions that can not be answered with “Yes or No”.

Then, follow up on the details, or simply ask “What else?”.

Example Scenario

Let’s say a woman is suffering from Alzheimer’s disease. She is already 85 years old.

Remembering does not come that easy for her anymore.

Most of the day she spends inside. Sitting in a comfortable chair while watching TV.

To apply the communication techniques, one might first create the proper atmosphere.

For example, joining her in the living room and serving her favorite cookies and tea.

Then, asking if she feels like answering some questions about her past.

Once she agrees one could start: “How was it back then in school, is there something you are happy to share with me?”

She might not answer directly.

Thus, one should be supportive and tell her: “Take your time, maybe you could start by telling me about your friends in school, or?”.

Now she replies: “Oh, I had a very good friend called Rose. We went through thick and thin.”

Dig in and ask what she means by “thick and thin”.

As you see, this sort of open question can help to sort through the memory.

When using reminiscence therapy it is important to be patient when asking an open question to someone with Alzheimer’s.

Every good story takes its time. And it's worth waiting.

A word from the author

So here you have it. Two techniques designed for everyday life with Alzheimer’s patients.

The reminiscence approach is suitable to try in everyday life.

And the validation approach is a favorable method to decrease tension due to mood changes.

I personally think that the mindset required to use the validation approach is difficult for most people, who try it the first time.

But, it makes taking care of an Alzheimer's patient easier.

So: "Definitely worth the try!"

Thank you for reading my article. I hope you found the examples and phrases helpful.

Feel free to send this article to friends and family.

List of Resources

Patric Pförtner

B. Sc. Psychology

Hi, my name is Patric Pfoertner and I graduated 2020 from the NBU. Currently, I work and study in Germany. My specialisations are Cognitive Psychology paired with a good slack of Clinical Psychology. Just this year I started publishing my research in the CBB Journal. Feel free to read about it at ResearchGate. Otherwise, click the other button to read my full CV.

About Author ResearchGate

P.S.: I am available for psychological consultation, too.