NURSING JOURNAL

Student’s Name: Carissa Mae T. Estrada Date: August 4, 2022

Year/Block/Group: 3BSN-13
Clinical Instructor: Maria Cecilita C. Lusung, R.N. and
Amelita Delos Santos Dumaguin, R.N.

THE IMPACT OF DEMENTIA ON COMMUNICATION

Dementia is an umbrella term used to describe a collection of diseases characterized by progressive loss
of cognitive functions and other abilities. Dementia has a neurological basis that is typically untreatable
and irreversible, and the greatest risk factor for developing it is age. People who are living with
dementia typically experience gradual but insidious decline in a wide range of abilities over a number of
years, which may ultimately result in them relying on family or formal caregivers to meet all of their
needs. As the illness progresses to the later stages, care is often provided in nursing homes or other
institutions. As such, staff members need to form relationships and get to know people who already
have significant communication difficulties by the time they meet.

As dementia progresses conversation becomes increasingly challenging and towards the later stages,
verbal language production may disappear altogether. People living with dementia may make nonverbal
attempts to communicate with caregivers but these are typically ignored, misinterpreted as ‘challenging’
or judged incomprehensible. The communicative difficulties experienced by people with dementia are
not only misinterpreted as signifying that they have nothing to contribute, but that they have actually
lost the desire to participate in the social world. This perception manifests in low levels of reported
social activity by people with dementia in residential care. For example, Bowie and Mountain (1993)
observed 110 people with dementia living in a long stay hospital ward, who they found spent only 5.5%
of their day involved in social engagement but 68% in neutral, i.e. no activity. Furthermore, the authors
noted that the majority of social engagement occurred during caregivers’ pursuance of basic activities of
daily living. In other words, people with dementia were only given the opportunity to engage in social
interactions when they were being helped to eat or assisted with personal care. Consequently,
individuals with advanced dementia often find themselves excluded from the social world and negated
as social agents.
References: Ellis, M., & Astell, A. (2017, August 1). Communicating with people living with dementia
who are nonverbal: The creation of Adaptive Interaction. PloS one. Retrieved August 4, 2022, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5538738/
Reflection:
Dementia is a rapidly growing unit, as the society is getting older, we can expect an increasing number of
people with dementia. If not affected, then as a potential caregiver or at least the neighbors of the
person with dementia, we can provide dementia friendly society only with a certain knowledge. In order
to promote cognitive functioning and independence among older adults, public health interventions
should also facilitate early detection and treatment of dementia. Communicative (speech and language)
difficulties, which are one of the groups of accompanying symptoms of dementia, should be recognized
as a consequence of neural degradation in order to provide the necessary help in time. Communication
is a very important segment of every person’s life, we use it to actively participate in society, pass on our
wishes and needs, and share attitudes, knowledge and experience with other members of the
community. Previous indicates the importance of ensuring the ability to communicate and adjust the
communication system if needed. Speech and language pathologists/therapists should be actively
involved in treating people with dementia through direct contact with affected persons for maintaining
communication skills or finding compensation strategies as well as working with their caregivers to teach
them how to communicate more adequately. Effective communication with older people is an
important aspect of nursing practice. Ineffective communication can lead to older people feeling
inadequate, disempowered and helpless. Nurses have a duty to ensure that older people think they are
being listened to and that their concerns are being validated in a non-judgemental way. Effective
communication can sometimes be difficult to achieve due to the effects of ageing, but nurses can
overcome some barriers through thoughtful interventions. It is important to treat older people as
individuals, and to monitor and adapt communication accordingly. By doing so, nurses can ensure older
people feel empowered, respected and able to maintain their independence. Good communication can
help people to live well with dementia.