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Life Health > Running Your Business

6 Tips for Communicating With Clients Facing Cognitive Decline

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What You Need to Know

  • Many clients are facing cognitive decline.
  • How do you get in harmony with those clients?
  • One way to start: Listen.

Good communication skills can enhance quality interactions with older adults and others who are dealing with cognitive decline or related problems.

As a music therapist for more than 20 years, I’ve made a career out of working with clients, families, and health care institutions with Alzheimer’s disease and other kinds of neurological challenges, and I lean on a handful of basic ideas for engaging with individuals in a positive and productive way.

When interacting with people with cognitive challenges, here are some best practices you may find helpful:

1. Listen to what the client is saying.

Be careful not to impose your own agenda on the conversation.

By really hearing what people are saying or trying to say, you can better understand their needs.

2. Be patient.

This may mean repeating yourself as well as repeating what you think they said, so information is clear to all parties, but be conscious of doing this in a way that is not demeaning to the clients.

3. Follow the client’s lead, verbally and non-verbally.

Let the client lead the conversation and try to understand both the big picture and the details around the client’s needs that will serve the client and the client’s care system best.

4. Match the client’s energy level, including volume.

This will help you avoid being overwhelming or demeaning.

4. Opt to meet with the client in-person or virtually.

Having an in-person conversation, or using a Zoom or FaceTime video call, can be beneficial in many ways. That gives people with cognitive challenges a chance to see the faces of the people they’re interacting with.

6. Remember that music can be both a conversation starter and a conversation obstacle.

Talking about music and musical preferences can often be a good way to build rapport, but, if a client is facing cognitive challenges, actually playing music can be very distracting, depending on the nature of the music, its volume, etc.

Be careful not to overwhelm clients with too much auditory and visual stimulus, especially when first meeting them.

That said, if your meeting is in person (this does not include video calls), having non-vocal, soft, relaxing music in the background can support a positive mood for conversation.

And remember that, even though clients may have cognitive deficits that can manifest as social or emotional challenges, they have lived full lives and have deep personal stories. Be respectful. Give them the dignity they deserve.


Andy Tubman. (Photo: SingFit.com)Andy Tubman, a board-certified music therapist, is the co-founder and chief clinical officer at Musical Health Technologies, which is also known as SingFit.com. He developed the SingFit strategy for using singing in health care.

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