Dementia and Alzheimers affect a person’s ability to understand and be understood. Know what you can do to improve communication and lessen frustrations.
Tips for communicating with a person with dementia
Dementia and Alzheimers affect everyone differently so it’s important to communicate in a way that is right for the person. Listen carefully and think about what you’re going to say and how you’ll say it. You can also communicate meaningfully without using spoken words.
Dementia and language
You are here: Tips for communicating with a person with dementia Non-verbal communication and dementia Dementia and sensory impairment: communicating Communicating and dementia – other resources
These tips apply to however the person usually communicates, for example speaking English or signing British Sign Language.
Every person’s experience of dementia is unique, so not every tip may be helpful to the person you care for. Use the tips that you feel will improve communication between you.
Why is communication important?
Communication is a vital part of our lives. It allows us to express who we are and relate to one another. Communication is more than talking and listening – it involves understanding and interpreting.
When a person living with dementia is having trouble expressing themselves or understanding what is being communicated, try these tips to help you stay connected.
1. Use what you know about the person
What does the person like? Use that knowledge to suggest conversation topics or activities they may enjoy.
Nurture the person’s skills and abilities. Focus on what they can do instead of what they can’t.
When the person is making a choice, offer them a couple of options that you know they will like.
2. Reduce distractions
Take note of possible visual or auditory distractions in the person’s environment and minimize them.
Account for any hearing or vision challenges the person may have.
Make eye contact to help focus the person’s attention.
3. Don’t ask a person with short-term memory loss a short-term memory question
A patient and/or loved one can construe even the simplest of conversation starters (“How are you today?”) as a real question, but they honestly don’t know the answer to it. This can be embarrassing and can send them back into a fog they try their best to give an answer that makes sense to them and often produce immediate physical concerns: “I’m having a lot of pain,” for example. A caregiver and/or family member might ask, “What did you have for breakfast?” and the person with memory loss doesn’t remember at all. They might say earnestly, “I haven’t had anything to eat for weeks,” (because they honesty can’t remember the last time they ate). So these are questions to avoid because it causes fear for the person, that they have failed. But there are things you can talk about (which is covered under Communication Do’s.)
4. Don’t correct them
A patient and/or loved one with memory loss often shows progression in terms of their problems with language. The first sign is finding the right words for things, or word accuracy. The patient and/or loved one may be telling you something about a letter they received, but they can’t get the word “envelope” out, or they may point to a lamp and they can’t quite get the word “lamp” out. Language starts to become disfluent, and it’s difficult for the person to find the specific, right word that they want to express. Over time, their language becomes increasingly vague it is more difficult for them to say something specific. For example, if you ask them what they do on a day-to-day basis, often they’ll say, “Oh, you know, I kind of do the same old thing. I kind of sit around a bit I do house things,” but they can’t offer specific details. This is because their store of language has become affected by the disease. In short, it is very difficult for them to express themselves in any great detail.
Another way to spot decline in language skills is substituting words. For example, they ask you to pass the salt when they meant to say sugar. Stop yourself from nitpicking them on accuracy: “You meant to say the sugar, so here’s the sugar.” Skip that whole conversation. You won’t teach someone how to talk, and, it can be construed as rude to ask that person to try a little harder, because they’re already functioning with half the brain cells. If they point at the sugar and ask for salt, just hand it over as if they said sugar. That’s the most respectful and kind.
People with dementia and/or Alzheimer’s may ask repetitive questions. Usually the question expresses a concern they have. Anyone with a concern that isn’t being addressed will become louder and more persistent. He/she may repeat the same question, because he/she cannot remember that he/she has just asked it, and their concern hasn’t gone away. It is the caregiver’s and/or family member’s responsibility to help soothe the worry. The goal is not to make the question go away it is to make the worry go away for a little while, and then the question may come back. It’s perfectly okay to give the same answer again if it helps to calm the patient and/or loved one. Certain situations throughout the day will trigger repetitive questions that’s to be expected.
5. Encouraging someone with dementia to communicate
Try to start conversations with the person you’re looking after, especially if you notice that they’re starting fewer conversations themselves. It can help to:
speak clearly and slowly, using short sentences
make eye contact with the person when they’re talking or asking questions
give them time to respond, because they may feel pressured if you try to speed up their answers
encourage them to join in conversations with others, where possible
let them speak for themselves during discussions about their welfare or health issues
try not to patronise them, or ridicule what they say
acknowledge what they have said, even if they do not answer your question, or what they say seems out of context – show that you’ve heard them and encourage them to say more about their answer
give them simple choices – avoid creating complicated choices or options for them
use other ways to communicate – such as rephrasing questions because they cannot answer in the way they used to Alzheimer’s Society
6. Find the right time of day
The first step to easier telecommunication with someone who has Alzheimer’s disease is to call at the right time of day. That’s when your loved one is rested and most alert.
According to the Alzheimer’s Association , Alzheimer’s disease affects the sleep-wake cycle. I’ve noticed this with my grandma, and I definitely noticed this when I worked at a memory care facility.
difficulty sleeping at night
drowsiness during the day
Scientists don’t know exactly why this occurs, but believe it’s due to Alzheimer’s-related changes in the brain.
My grandma tends to get out of bed late in the day, around 11 a.m. or noon. She is most alert in the early afternoon, so this is when I call. Since she lives in assisted living, I also avoid calling at mealtimes or when there are group activities.
Instead of trying to change your loved one’s sleep cycle or schedule, recognize the impact of their disease and work with them.
Know that finding the best time of day to call might take some trial and error, and it might change as their disease progresses. Talking to caregivers or keeping a calendar of symptoms can help you find the best time to call.
7. Simplify your language
It’s easier said than done, but one of the best things you can do to aid communication is simplifying your language.
According to Bennett, “Usually we add a lot of fluff and storytelling to our main point, but individuals with dementia might get lost in all that fluff.” Try using as few words as possible with simple, common phrases. Cut out modifiers and shorten your sentences. Bennett even recommends pairing visual supports like pictures or props over video chat to get your point across.
I’ve found that avoiding open-ended questions can help.
I ask yes or no questions or give two options. This can help prevent overwhelm and limit the cognitive resources required to communicate, saving energy for the rest of the conversation.
The Power of Memory
The brain works in funny ways. While someone with dementia and/or Alzheimer’s may not be able to recall what he/she had for breakfast that morning, he/she may remember people, places, and stories from the distant past. Remember: ask the patient and/or loved one to share favorite stories from childhood family members may even be surprised to learn something new.
Also keep in mind that even though the patient and/or loved one is losing his/her memory, he/she still has feelings and emotions. Humor offers a great way to connect, and everyone can reap the mood-boosting benefits.
Communicating with a patient and/or loved one with memory loss has its challenges, but these proven techniques can help caregivers whether you are a professional or a family member overcome the barriers in order to continue to connect.