Any communication between people has two main, strongly related purposes:

• the sharing of meaning.
• the fostering of social connections between people.

Communication is a basic human need and, as such, making it as effective as possible should be a basic human right. Communication enables us to project our identity and to have our identity confirmed. Communication can be seen as a process, as well as an act, or series of acts.

Briefly, seen as a process, it consists of:

• communicators (the people involved in the conversation).
• the message (what people are ‘trying to say’).
• the medium (presentational: the voice, face, body; representational: words, pictures, architecture; or mechanical: TV, computer, telephone).
• the channel (vocal, gestural/visual, chemical/olfactory, tactile).
• a code (a system of meaning shared by a group, for example, a language).
• noise (factors tending to blur the message, for example, misunderstandings arising from ‘misreading’ body language, as well as background environmental distracters like loud music).
• feedback (things which allow the message sender to be able to judge whether they have been understood).
• context (who is communicating with whom, when, where and with what presuppositions and expectations).

People living with dementia may:

• be easily disorientated.
• experience a sense of loss of purpose and identity.
• feel uncomfortable exploring/exposing their diminished competences.
• be anxious about their condition and its possible progress.

As a consequence, they may:

• have difficulty following rapid or complex speech.
• attempt to convey meaning in ways that are discontinuous and lacking in logical structure, but may express underlying concerns in a way that can be understood intuitively.
• have difficulty encoding or decoding meaning.
• be especially susceptible to ‘noise’, be it environmental, socio-cultural or situational.
• find some behaviours unhelpful in others’ attempts to communicate – for example, a perceived patronizing tone or a too-rapid action accompanying an explanation.

We believe that people with dementia should be:

• agentive, i.e. able to be in control of their own lives and circumstances as far as possible.
• offered support in continuing to ‘own’ a clear idea of themselves as individuals, and of themselves in a particular socio cultural context.
• helped to feel less anxious.
• aided in their attempts to negotiate and maintain a sense of self and of personal and social identity.
• assisted in their attempts to communicate effectively with others.
• helped to retain and regain competencies.
• approached and treated in such a way that their dignity and freedom of choice are reinforced and supported.

Dementia can profoundly affect a person’s ability to communicate effectively.

People living with dementia are, nevertheless, individuals with communicative needs. Addressing these needs in a clear and principled manner, which fully acknowledges individual ‘personhood’, is a key element in any positive encounter between people with dementia and their carers.

Overall, a person-centred approach to communication between carers and those living with dementia should have the effect of initiating a virtuous circle of improving communication.

With this, the recognition of a person’s individual agency by a carer both increases the individual’s sense of competence and improves the quality of social interaction for both parties.

These principles are at the heart of DemTalk.