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Dementia and Communication

With age, many of our patients may be at higher risk of developing dementia. Dementia has a wide range of causes and symptoms, and is most often associated with Alzheimer’s disease. Memory loss, difficulty in communicating, in organizing complex tasks and in coordinating motor functions can add to the challenge of participating in rehabilitation. In pelvic rehabilitation, we are already faced with the importance task of effectively communicating about sensitive topics, obtaining clear consent, and instructing in exercise that may be difficult for the patient to “see” or appreciate in the same way as with a biceps curl or leg raise. How can we set ourselves and our patients up for success when working with a patient who has dementia or other cognitive issues?

An article with a focus on communication with older people who have dementia de Vries, 2013 summarizes practical information that can positively affect our skills in communication with patients who have cognitive dysfunction. From the impact of hearing loss on orientation and sense of vulnerability, to the types of listening skills recognized as means to improve communication, the article integrates a wide range of valuable information.

Some of the suggestions for enhancing interactions with patients who have dementia come from the work of Wilson et al., 2012, and include the following:

  • slow the rate of your speech
  • use verbatim repetition
  • ask questions that can be answered with a “yes” or “no”
  • decrease the complexity of your sentences
  • ask one question at a time give instructions for one idea or concept at a time
  • avoid use of pronouns when able (can be confusing, refer instead to the person)

Other research-based advice given in the article includes eliminating distraction, such as turning off a radio or television, and avoid interrupting the person who has dementia. Sitting face to face is recommended, as is using non-verbal communication such as facial expressions and gestures. Also very interesting is the idea that using a more controlling tone of voice can lead to increased resistance to care. A terrific strategy that is recommended in the article is this “Ask a colleague to observe your practice…and make notes on how you communicate…” Although being critiqued may feel intimidating, learning how others perceive our use of the above skills can help to optimize communication with patients who have dementia.

Providing optimal communication strategies during rehabilitation is just one of the topics that is discussed in the Institute’s new Geriatric Pelvic Floor Rehab continuing education course. The first opportunity to take this new course is Tampa, Florida this January. The course is taught by Heather Rader who immerses herself in the care of people in the geriatric age range. Her expertise not only in pelvic rehab, but also in adaptations for the geriatric population, billing practices, and marketing will be shared.


De Vries, K. (2013). Communicating with older people with dementia. Nursing older people, (25), 30-7.

Wilson, R., Rochon, E., Mihailidis, A., & Leonard, C. (2012). Examining success of communication strategies used by formal caregivers assisting individuals with Alzheimer’s disease during an activity of daily living. Journal of Speech, Language, and Hearing Research, 55(2), 328-341.

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Mindfulness and Chronic Pelvic Pain

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Upcoming Continuing Education Courses

Yoga for Pelvic Pain - Remote Course

Jul 31, 2021 - Aug 1, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Marietta, GA Satellite Location (SOLD OUT)

Aug 14, 2021 - Aug 15, 2021
Location: Southern Pelvic Health

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Aug 14, 2021 - Aug 15, 2021
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Aug 14, 2021 - Aug 15, 2021
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Aug 14, 2021 - Aug 15, 2021
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Sexual Interviewing for Pelvic Health Therapists - Remote Course

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Aug 14, 2021 - Aug 15, 2021
Location: Physical Therapy of Tulsa

Pelvic Floor Level 1 - Self-Hosted

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Oncology of the Pelvic Floor Level 1 - Remote Course

Aug 15, 2021 - Aug 16, 2021
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Pelvic Floor Level 2A - Troy, NY Satellite Course (SOLD OUT)

Aug 21, 2021 - Aug 22, 2021
Location: The Green Room Physical Therapy

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Aug 21, 2021 - Aug 22, 2021
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Aug 21, 2021 - Aug 22, 2021
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Aug 21, 2021 - Aug 22, 2021
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Aug 21, 2021 - Aug 22, 2021
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Sacroiliac Joint Current Concepts - Remote Course

Aug 21, 2021
Location: Short Form Remote Course

Pelvic Floor Level 2A - Belle Chasse, LA Satellite Course

Aug 21, 2021 - Aug 22, 2021
Location: Rehab Access Belle Chasse

Pelvic Floor Level 2A - Las Vegas, NV Satellite Course

Aug 21, 2021 - Aug 22, 2021
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Aug 21, 2021 - Aug 22, 2021
Location: Palos Community Hospital

Pelvic Floor Level 2A - Syracuse, NY Satellite Location

Aug 21, 2021 - Aug 22, 2021
Location: SUNY Upstate Medical University

Pelvic Floor Level 2A - Self-Hosted

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Aug 21, 2021 - Aug 22, 2021
Location: Thayer County Health Services

Pelvic Floor Level 2A - Boston, MA Satellite Course

Aug 21, 2021 - Aug 22, 2021
Location: Professional Physical Therapy

Postpartum Rehabilitation - Remote Course (SOLD OUT)

Aug 22, 2021 - Aug 23, 2021
Location: Replacement Remote Course

Pelvic Floor Level 2B - Tinton Falls, NJ Satellite Course (SOLD OUT)

Aug 28, 2021 - Aug 29, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Level 2B - Grand Haven, MI Satellite Course (SOLD OUT)

Aug 28, 2021 - Aug 29, 2021
Location: Ivy Rehab Physical Therapy

Pelvic Floor Level 2B - Los Angeles, CA Satellite Course (SOLD OUT)

Aug 28, 2021 - Aug 29, 2021
Location: Origin Physical Therapy

Pelvic Floor Level 2B - Sacramento, CA Satellite Course

Aug 28, 2021 - Aug 29, 2021
Location: East Sacramento Physical Therapy