Mask wearing can create communication challenges with elders and people with dementia. Two eldercare experts have developed a simple tool to help clinicians convey sincerity and meaning – despite COVID-19 challenges.

Nonverbal communication not only presents an opportunity to connect with frail, older adults, it is also thought to be the most effective way to communicate with a person who has dementia, write geriatrician Mathias Schlögl, M.D., MPH, and palliative care specialist Christopher Jones, M.D., MBA. 

“They can tell from the sound of our voice, our posture, and our speed whether we are relaxed or stressed, in a good mood or angry. A lot of this is missing right now – and many of us don’t even realize it.”

When embraced intentionally, the following ABC mnemonic (summarized here) can help, say the doctors.

Attend mindfully: Focus your attention before a visit. Align nonverbal signaling with your spoken message. “If we don’t practice the habit of underlining everything we say with gestures and pantomime, the message we convey might be harder to interpret.”

Behave calmly: Approach elders from the front and respect personal space, but drop down to meet them at eye level. Refrain from sudden movements to avoid creating distress. “Project a positive, calm attitude and avoid body language that shows frustration, anger, or impatience, while trying not to interrupt them and give them your full attention.”

Communicate clearly: Avoid noise and overwhelming stimulus and make sure the senior is wearing glasses or hearing aids, if needed. Slowly communicate one point at a time. Use short, simple sentences and underline your words with gestures. Keep your voice even, tone gentle, and speech slow. Speak louder, if needed, because lip-reading cues are absent with a mask.

Schlögl is from the University Hospital Zurich, Switzerland, and Jones hails from the University of Pennsylvania. A more detailed explanation of the mnemonics tool can be found here.