Keeping a conversation going with people living with more advanced dementia can be challenging, but there are ways to ensure you can keep talking. Helen Johns explains how using a ‘no wrong answers’ method can support communication and help strengthen relationships.
Sometimes it is difficult to keep a conversation going. Conversations usually include an exchange of information, thoughts and observations and can be supported by a few well-chosen questions. Activity coordinators and carers often say that they get nervous about asking the wrong questions and sometimes it can feel like a minefield. This is especially true if the person is living with dementia and their cognitive ability it is not obvious.
- Factual Questions: If we ask for specifics, we may put people on the spot and they may feel anxious about getting the answer right. (Ie Who is the person in the photo? Where was that photo taken?)
- Memory Questions: If we ask ‘Do you remember?’ questions, we may highlight potential deficits in memory. (Ie Do you remember when you used to work at the hospital?)
- Open-ended Questions: If we ask questions that are too open-ended, we may be providing too wide a choice which may overwhelm the person. (Ie Where is your favourite place in the world?)
QUESTIONS THAT HAVE NO WRONG ANSWERS
These are questions that focus on people’s choices, preferences, opinions, thoughts, and ideas. As these will be individual to the person you are talking to, they will be valid regardless of whether the response includes accurate facts.
We have found that when supported by a visual cue that can be referred to (eg a photo, the room you are in, other props etc) they can provide no-fail answer options. Using these as part of a wider conversation they can help the discussion flow and build relationships.
Choice: Showing two or more items and asking: Which do you prefer? Which would you buy?
Preferences: Which one do you like? Which one is your favourite?
Thoughts: What do you think of this colour? How does this look to you?
Opinions: What do you like about that painting/book etc? What do you think of recycling?
Feelings: How do you feel? How do you feel about x? How does that make you feel?
Comparisons: Which is the odd one out? Which one makes you smile? Which one looks most expensive?
Others you could try: What do you like about this room/book/chair etc?
These types of questions are used effectively as part of Cognitive Stimulation Therapy and can be really effective in getting people talking, and then keeping them talking too.