No one likes to feel left out of the conversation – including people living with dementia. Sometimes, all it takes is a little extra thought to make sure everyone feels included.

Here are some things you can do to help make communication a bit easier when someone you know is living with dementia.

Some basics

Dementia is an umbrella term for a group of brain diseases which can impact memory, language and how people communicate.

Specific types of dementia can affect someone’s understanding of the meaning of words or their ability to produce language.

People with dementia may find it hard to find the right words, or it might take them longer to process information.

Changes in memory and thinking can also make it hard to keep up with conversations and remember what you wanted to say.

Dementia affects each person differently. There is no one way of talking to people living dementia, just as there is no one way of talking to any group of people.

But the principles remain the same

People with dementia continue to face high levels of discrimination and stigma.

But fundamentally, how you talk to someone living with dementia is the same as talking to anyone else.

Communicating means being clear and showing respect, and not assuming what the other person may or may not be able to understand.

When someone has dementia, you may have to adapt and simplify some of the ways you communicate. But it’s important to do this without talking down or infantalising them.

Control what you can

If your friend or loved one with dementia often finds communicating challenging, planning ahead can make a difference.

Most of us would find it harder to concentrate in a busy cafe with the coffee machine roaring, music playing and background conversations. But for someone with dementia this can be particularly overwhelming.

Wherever possible, choose a quiet space to catch up, and limit the group to one or two people. If you’re in a bigger gathering, consider having someone stay with the person with dementia to support them if they start to feel overwhelmed.

Communication is both verbal and non-verbal. So make sure there is good lighting and that you sit where the person with dementia can see you.

If they (or you) use hearing or visual aids, make sure they’re worn and on. And put down your phone – giving the person your full attention can help them anchor theirs.

Using expressive body language – such as smiles and nods – can help convey meaning.

Let them lead

Sometimes people with dementia may say things that are out of place. They may also refer to people or things from the past as if they’re here today.

When this happens, it’s natural to want to correct them, but it’s not the best approach. Lying should also be avoided wherever possible.

So what can you do instead? Focus on alleviating their distress, validating their emotions or redirecting the conversation.

You can try to understand what they’re feeling or experiencing. If someone asks for their mother, for example, it could be a sign they need comfort. After checking for anything else that could be causing distress, you could acknowledge they miss their mum, but explain she’s not here right now.

Where appropriate, touch can provide comfort and help redirect the conversation.

Reminiscing can also be positive. If they ask about a specific person or place, a memory book can help prompt recollections of good times they’ve shared.

Of course, not all family relationships or past experiences are positive. If you know there are difficult topics or relationships, try to let the care team or other people around them know the person’s history so they can watch for signs of distress.

More practical tips

Inclusion should always be the priority. So try to speak directly to the person living with dementia, not about them.

Use their name, and don’t be shy to introduce yourself and remind them how you know each other. For example, “Hi Brenda, I’m John. We met at tennis.”

Don’t rush to finish their sentences. Slow down and give them time to respond.

Show interest in what you know about the person from their past. Ask questions, but remember – providing context can make it easier to answer: “I’ve been enjoying Wimbledon. Have you got a favourite tennis player?” or “It’s a lovely day outside. Shall we see what’s growing in the garden?”

Music is also a wonderful way to connect and may help reduce depression. Listening to familiar songs can be a way to spend time together without the pressure of a conversation. Or you might find other ways to connect through art, gardening or spending time with grandchildren.

Good days and bad days

Dementia is progressive, so it will get worse over time.

However, symptoms can change depending on the time of day, and daily fluctuations are more common in some types of dementia.

As for any of us, feeling tired, unwell or in pain can make it harder to pay attention.

But if you notice a sudden change – such as the person not knowing where they are, hallucinations or a mood shift – check for infection or recent medication changes, and seek help. These could be signs of delirium, which is a medical emergency.

Remember that you’re human, too

Caring for someone living with dementia can also affect your own health and wellbeing. It’s important to take time out for yourself, connect with support services, ask for help, and remember that we all make mistakes.

When someone has dementia, challenges communicating are not anyone’s fault. But slowing down, being patient and listening can make a world of difference.

Nikki-Anne Wilson, Lecturer, School of Psychology, UNSW ; Neuroscience Research Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The ins and outs of some of the seemingly endless fights over the Albanese government’s budget measures are often arcane or difficult for many people to easily understand.

That’s the case, for example, with the legislation to crack down on trusts, introduced on Wednesday, which has been surrounded by a lot of heat.

But the tug of war over the government’s plan to remove, from April next year, the age discrimination that favours older people taking out private health insurance is a very simple issue for voters to get their heads around, wherever they stand on the merits of the measure.

It’s now a central battle for the government and it will be hard for it to rescue the measure without sacrificing big dollars – just when Treasurer Jim Chalmers needs to preserve the budget’s savings.

In terms of personalities, there’s a lot to watch too, with new Greens leader David Shoebridge and Health Minister Mark Butler as main players.

Both have something to prove in how this ends. It’s Shoebridge’s first big legislative test in his new role, and he flagged earlier the Greens would be more assertive under his leadership.

For Butler, seen as one of the frontrunners to eventually succeed Anthony Albanese, it will be another benchmark of his ability to land a deal – providing clues on how well he will handle the complexities ahead in his job of reforming the National Disability Insurance Scheme.

Under present arrangements, people 65 and over who have private health insurance receive a bigger rebate than those who are younger. The amount is larger if they are 70 or older.

By removing the “top ups”, the government would save $3 billion over four years. It has said this would be put into aged care, which is much in need of money.

Its justification for the measure is equity – that it is unfair that people should be treated differently on the basis of age.

On Wednesday the opposition, Greens and other crossbenchers joined in the Senate to knock the legislation off the government’s agenda.

The Greens say that, as the price of passage, they want pensioners removed from its ambit. “You can’t take a billion dollars from 1.2 million pensioners,” Shoebridge says.

Butler on Thursday reintroduced the bill into the House of Representatives. Its future was unclear when parliament broke late Thursday. The weeks ahead will see negotiations between the government and Greens.

There’ll be plenty of time for the bill’s critics to intensify their lobbying, which has already been full on. One Labor backbencher, receiving a flood of emails, says the measure is causing a lot of pain in electorate offices. This MP thinks the government should at least remove pensioners from those hit, if not drop the bill entirely.

Teal independent Monique Ryan, a medical doctor, has been a strong critic, commissioning data from the Parliamentary Budget Office (PBO).

Ryan said after the Senate vote: “It’s unfair and unreasonable to strip support from older Australians who have worked for decades to retain their private health cover in retirement.

"The PBO analysis I commissioned found that half the $3 billion in savings the government had planned would have been taken from the pockets of the older Australians least able to afford them.”

Ryan accuses the government of trying to hide the impacts of the changes. “It claimed that 44,000 older Australians might drop their cover because of these changes. The Health Department says it is closer to 80,000. That would shift the cost of their healthcare to public hospitals, and the government has refused to say how much that would cost the states.”

For the government, and in particular the treasurer, the rejection of the health rebate bill capped off yet another fraught week, which saw Chalmers embarrassed when the prime minister seemed to be claiming all the ownership of last week’s backflip over the Australian Taxation Office’s credit card ban.

This budget has such a long tail that it is running into the preparations for the mid year update, due in December. Many concessions and corrections have had to be made. At the macro level the news continues grim, with the latest International Monetary Fund’s World Economic Outlook this week showing Australia expected to have continuing high inflation, in the top band of developed countries. Thursday’s job figures showed unemployment at 4.7% in September, a five year high.

Expectations remain of another interest rate rise in this cycle, But Chalmers will fervently hope the Reserve Bank will press the pause button at its early November meeting, as is currently considered likely. Thursday’s jobless numbers increase the prospect of a hold in November.

Chalmers finds himself under the most pressure that he has experienced in his time as treasurer, with no relief in sight and the budget update looming as yet another test.

Given his present problems and preoccupations, it was interesting that Chalmers this week delivered a major speech recognising the risks posed to Labor by One Nation and warning the progressive side of politics not to insult those attracted to voting for that party.

It was a timely reminder, as One Nation appears an increasing threat to Labor. A landmark test for the left side of politics will be next year’s New South Wales election where, despite the Minns Labor government having a reasonable record (unlike Victorian Labor), One Nation appears to be gaining quite a strong foothold.

For the federal opposition, on the objective evidence this week should have been a very good one, with the government seriously on the back foot. Yet Angus Taylor and the Coalition still fail to present as a credible alternative, a message reinforced by implication in former treasurer Josh Frydenberg’s autobiography, released this week.

Many in the current parliamentary Liberal party are highly critical of the former Liberal deputy leader producing the book now, or at all. But the point is, while people may dispute the solutions Frydenberg offers, he has held a mirror to the Liberals’ problems and inadequacies. The party has to fix what the mirror shows – it’s no good just panning the man holding it.

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.