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    Dementia Symptoms & Caregiver Strategies: Cognitive Impairment and Using the Telephone

    At certain stages of cognitive impairment the person you care for might have increased difficulty operating the telephone. This can include problems dialing or pushing the buttons, hanging up incorrectly or talking into the wrong end of the phone. Sometimes remembering phone numbers, who they are talking to, or putting down the phone and forgetting that he or she was engaged in a conversation can also be challenges. The individual may also have difficulty identifying the sound of the phone ringing or may refuse to answer the phone when it rings.

    In addition, there is increased concern about the potential for telephone fraud and telemarketer harassment with people who are suffering from cognitive challenges. You might find it useful to discretely supervise access to the telephone to limit this threat.

    Common Signs of Difficulty Using the Phone:

    • Misdials numbers recalled from memory
    • Uses a phone list or address book to dial previously memorized numbers
    • Misdials phone numbers even when referring to phone list or address book
    • Frequently misdirects calls (e.g. intends to call son but dials pharmacy instead)
    • Only able to place calls if numbers are preprogrammed
    • Is reluctant or refuses to answer the telephone when it rings
    • Is reluctant or refuses to talk on the telephone
    • Will talk on the telephone but does not initiate calls to others
    • Hangs up abruptly during telephone conversations
    • Forgets to write down or verbally relay phone messages
    • Records or relays phone messages incompletely or incorrectly
    • Has trouble with or cannot use special functions (e.g. voice mail, speed dial buttons, etc)
    Tips to Make Phone Use Easier:

    How to best deal with your loved one’s problems using the telephone depends on your specific situation. Here are some ideas to consider:
    • Eliminate land lines and switch to cell-only service if you live in the same house as someone with cognitive impairment.
    • Place telephones only in the rooms where the individual doesn't go (for example, in your bedroom or in a landing at the top of the stairs).
    • Use call-forwarding so that home calls go to your cell.
    • Turn down ringers (this may prevent the phone from being answered but will not prevent outgoing calls).
    • Use caller ID to follow up on who phoned.
    • Consider an easy-to-use phone which has visual-cue buttons so the user can easily dial family members or emergency help (here’s an example:
    • Another option: a dial-less phone which receives calls but doesn't permit dialing – a possible substitute for those who like to call at all hours (here are some examples:
    Finally, consider that not being able to dial for help or emergency services is not merely a sign of cognitive decline but may be a signal that your loved one may no longer be able to live alone.

    Cognitive Impairment can have many causes. The patient’s doctor should be consulted to determine a specific diagnosis and treatment options. But whatever the cause, the symptoms are often alike, and the Caregiver Strategies are often similar.

    The information in the resources listed above was compiled by the Ray Dolby Brain Health Center through clinical experience and commonly available published materials. For information on additional Caregiver Strategies, go to: