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| Clinical approaches | Communication techniques | PwP-caregiver dynamic |
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| (i) Select the priority issues to address | (i) Consider use of images | (i) Allocating caregivers specific time to discuss their concerns about the PwP and also to explore their own needs |
| (ii) Make a single recommendation at any one time | (ii) Consider simple hand signals to supplement verbal communication (e.g., touch the chair when asking someone to sit) | (ii) Simultaneous multiprofessional consultations: PwP and caregiver each with a different HCP |
| (iii) Regularly reinforce recommended strategies | (iii) Speak slowly and simply, with concise phrases | |
| (iv) Minimise anxiety, e.g., calm environment; utilise familiarity (e.g., could lead the conversation from photographs); use of music; if a topic provokes anxiety, pause and come back to it later | (iv) Allow time, use pauses, listen patiently |
| (v) Be flexible, e.g., optimal timing for the PwP; let pace be guided by the PwP, recognise what aspect of the interaction is difficult for the PwP; and split discussion into shorter conversations if needed | (v) Reflect back and check understanding with the PwP (caution: asking the caregiver about PwP understanding may be perceived as patronising) |
| (vi) Be open about what to expect | (vi) Be mindful about language (e.g., the term “dementia”) |
| (vii) Normalise advanced care planning topics | (vii) Directly acknowledge communication difficulties, reassure and ask how the PwP wants them to be handled |
| | (viii) Minimise topic switching |
| (ix) Explain purpose before launching into questions |
| (x) Prompt, without dwelling on the forgetfulness |
| (xi) Utilise techniques identified as helpful by others involved (e.g., SLT recommendations) |
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