(646) 355-8777

Herman & Wallace Blog

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.

What does Vitamin D have to do with the Pelvic Flo...
Mindfulness and Chronic Pelvic Pain

Upcoming Continuing Education Courses

Bowel Pathology and Function - Remote Course

Feb 28, 2021 - Mar 1, 2021
Location: Replacement Remote Course

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Self-Hosted Course

Pelvic Floor Level 1 - Brooklyn, NY Satellite Location (SOLD OUT)

Mar 1, 2021 - Mar 2, 2021
Location: Prime Fitness Physical Therapy

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Mar 5, 2021 - Mar 6, 2021
Location: Replacement Remote Course

Mobilization of Visceral Fascia 2: The Reproductive System - Valencia, CA Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Henry Mayo Newhall Memorial Hospital

Mobilization of Visceral Fascia 2: The Reproductive System - Medford, OR Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Asante Rogue Valley Medical Center

Mobilization of Visceral Fascia 2: The Reproductive System - St. Louis, MO Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Mercy Hospital St. Louis

Mobilization of Visceral Fascia 2: The Reproductive System - Jackson, WY Satellite Location

Mar 5, 2021 - Mar 7, 2021
Location: Four Pines Physical Therapy

Male Pelvic Floor - Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Replacement Remote Course

Male Pelvic Floor - St Paul, MN Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Regions Hospital

Male Pelvic Floor - Kenosha, WI Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: Aurora Health Care

Pelvic Floor Level 2B - Self-Hosted (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Self-Hosted Course

Male Pelvic Floor - Atlanta, GA Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: JMM Health Solutions LLC

Male Pelvic Floor - Akron, OH Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Summa Health Center

Pelvic Floor Level 2B - Oklahoma City OK Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Oklahoma Physical Therapy

Male Pelvic Floor - Asheville, NC Satellite Location

Mar 6, 2021 - Mar 7, 2021
Location: Cornerstone Physical Therapy

Pelvic Floor Level 2B - Little Rock, AR Satellite Course (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Core Pelvic Physical Therapy

Pelvic Floor Level 2B - Truckee, CA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Tahoe Forest Center for Health and Sports Performance / Alliance Therapy Partners

Pelvic Floor Level 1 - Self-Hosted (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Self-Hosted Course

Pelvic Floor Level 2B - Torrance CA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Women's Advantage Inc

Pelvic Floor Level 2B - Grand Rapids, MI Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Mary Free Bed Rehabilitation Hospital

Pelvic Floor Level 1 - Jonesboro, AR Satellite Location (SOLD OUT)

Mar 6, 2021 - Mar 7, 2021
Location: Arkansas State University

Pelvic Floor Level 2B - Williamsburg, VA Satellite Course

Mar 6, 2021 - Mar 7, 2021
Location: Peak Therapy and Sports Rehabilitation

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

Mar 6, 2021 - Mar 7, 2021
Location: Mendelson Kornblum Physical Therapy

Biofeedback for Pelvic Muscle Dysfunction - Tampa, FL Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Optimal Performance and Physical Therapies

Biofeedback for Pelvic Muscle Dysfunction - Denver, CO Satellite Lab Course

Mar 6, 2021 - Mar 7, 2021
Location: Kelsey Mathias OTR/L

Acupressure for Optimal Pelvic Health - Remote Course

Mar 6, 2021 - Mar 7, 2021
Location: Replacement Remote Course

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

Mar 6, 2021 - Mar 7, 2021
Location: Thrive Integrated Medicine