Verbal Skills

1. Process

   • Introduce yourself to the person first.
   • Call the person by a nickname of his or her choice upon his or her approval.
   • Say thank you before ending the conversation.

2. Content

   • Start a conversation with common topics such as the events that happened that day, people the person has met, places visited that day, and the weather that day.
   • Continue the conversation with topics that the person is familiar with.

3. Dialogue

   • Provide choices inside your questions for the person to choose from, as in "Would you like rice or noodles?"
   • Use simple sentences and simple words.
   • Avoid the use of pronouns, such as "he," "she," "it," "that," and "something."
   • Adjust your voice and speed when talking; speak clearly and avoid giving an impression that you are rude or angry.
   • Avoid giving too many messages at a time.
   • Avoid treating the person as a child.
   • Avoid commanding the person.
   • Give the person enough time to respond.
   • Encourage the person to respond by praising with smiles or words immediately when the person responds.
   • Be patient and listen.
   • Praise the person more.
   • Avoid arguing with the person.

Aims:

Keeping you and the person happy.

How to do it at home:

1. Look for gains and positive meanings. For example:

   • After knocking over a glass, the person tries to wipe up the water on the floor with his hands.

     Your response: "You are trying to help. Thank you! I'll grab a towel and clean it up with you."

   • The person brings home a lot of fruit again.

     Your response: "Thank you for bringing so much fruit. Let's finish them before we buy more."

     • Post a note on the entrance door at night, like "There's fruit in fridge. No need to buy. Thank you, Mum/Dad/Sweetheart!"
     • Remind the person before he or she goes out, such as saying "There's still plenty of fruit in the fridge, so you don't need to buy any more today."
2. Discover the person's needs from his or her behaviour and address needs. For example:

   • The person makes a mess of her room when looking for something.

     Your response: "You are looking for something. It must be a valuable thing. Let me look for you so you can take a rest."

   • The person requests to go home after you take him to a restaurant, saying the place is too noisy.

     Your response: "They are just too excited about meeting you. Let's eat something and see what they are so excited about!"

Aims:

Maintain or enhance specific cognitive function or behaviour.

How to do it at home:

1. Provide cues for the person to express himself or herself. For example:

   • The person says "Let's go there" repeatedly.

     Your response: "Do you want to go to the department store or the supermarket?"

   • The person goes in and out of his or her room.

     Your response: "You're looking for something. Do you want something to drink or eat?"

2. Provide directions for the person to finish his or her task. For example:

   • The person puts on underwear over trousers after bathing.

     Your response: "I brought some new clothes for you. Let's try them on. I have to return them if the size doesn't fit."

     • Tell the person what to do from the first step, as in "Try the short one first."
     • Guide the person to the next step after putting on the underwear, such as in saying "Try the long one now."

   • The person starts to brush his or her teeth without toothpaste.

     Your response: "Mum/Dad/Sweetheart, you can rinse your mouth, put some toothpaste on the brush and continue brushing your teeth."

Aim:

Decelerate cognitive decline.

How to do it at home:

1. Tell the person about time, people, places and events. For example:

   • In the morning

     "Good morning, Mum. I am your daughter-in-law, (name). Today is (month), (day), (year). It is (day of the week) and it is (season). Let's get up and eat breakfast."

   • During a meal

     "Dad, it is (time) now. It is time for (breakfast/lunch/tea/dinner). We will have (food), (food) and (food) today. Let's go to the table first."

   • When taking medications

     "Mum, we just finished (breakfast/lunch/tea/dinner) and it's time for taking your three pills. Take this red one first. Now take the second one. Now the third one." Afterward, say, "You have taken all three pills. You will have your pills again at (time). Let's do something else now."

   • In the lift

     "Dad, we have to press (floor number). We are now living in (room) (floor) (building) (road) (district)."

   • At the bus station

     "Mum, we will take the number (route number) bus home now. We will get off at (bus stop)."

   • At night

     "Dad, it is (time) now. It is time to sleep. You can go to the toilet first before you sleep. I will turn off the light for you."

2. Let the person check the time for himself or herself.

   • Put a clock in an eye-catching place. The words on the clock must be big and easy to read.

   • Put a calendar in an eye-catching place. The words on the calendar must be big and easy to read.

Aims:

Maintain and enhance specific emotions or behaviour, especially for someone with late-stage dementia who has limited language ability.

How to do it at home:

Feel the "reality" of the person; validate and help the person to express his or her feelings and feel that he or she is being understood. For example:

1. You can do the following when the person repeatedly calls a spouse who has passed away:

   • Centering.

     Breathe with abdominal breathing five times.

   • Describe their behaviour or need for the person. For example:

     "You are looking for (name)."

   • Match their emotion or need.

     Feel the longing and dependency of the person for his or her spouse.

   • Rephrase their emotion or need. For example, you can say:

     • "You are missing her. You love her so much."
     • "Do you want her to look for your glasses?"

   • Express their emotion till they calm down. For example:

     • Refer to the emotion, as in "Are you feeling lonely?"
     • Ask for the critical, as in "What do you miss most about her?"
     • Prompt reminiscing, as in "How did you meet her?"
     • Tap into the senses, as in "What did she look like?"
     • Find the needs, as in "Do you want to see her? What will you do if you see her?"
     • Find solutions, as in "What things have you done in the past to make yourself feel better?"

   • Orient to the reality. For example, you can say:

     "It is time for dinner. You can wait at the dinner table now. I will be back soon."

2. You can do the following when the person requests to go home when he or she is at home.

   • Centering.

     Breathe with abdominal breathing five times.

   • Describe the behaviour or need for the person. For example:

     "You want to go home."

   • Match their emotion or need.

     Feel the significance and security of "home" to the person.

   • Rephrase their emotion or need. For example, you can say:

     "You are worried about your children. You are such a good mother."

   • Express their emotion till they calm down. For example:

     • Say their emotion, as in "Are you scared?"
     • Ask for the critical, as in "What do you worry about most?"
     • Prompt reminiscing, as in "What does your home look like?"
     • Tap to the senses, as in "What does your daughter look like?"
     • Find the needs, as in "Who are you waiting for? What will you do when your daughter comes home?"
     • Find solutions, as in "What things have you done in the past to make yourself feel better?"

   • Orient to the reality. For example, you can say:

     "Your daughter has to work hard now so she can take you to the restaurant this Sunday. Let's watch TV together and wait for her now."