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How to Communicate with People Who Have Dementia

Dementia is a progressive illness. It affects how the brain functions and leads to memory loss and other cognitive problems. Dementia can ultimately affect one’s ability to speak and communicate with others. All this can leave those in the family or social orbit of the sufferer at a loss as to how to communicate to people with dementia.

In some stages of dementia, it’s not uncommon for individuals to experience difficulty recalling words or focusing during a conversation. As the disease progresses, many individuals rely on other forms of communication, such as hand gestures and some vocal sounds. While nearly 50 million individuals suffer from dementia worldwide, many caregivers still struggle with how to communicate with someone with dementia. According to the National Institute on Aging, these are common effects of Alzheimer’s disease and other forms of dementia on the ability to communicate:

  • Losing a train of thought when speaking
  • Having difficulty understanding what words mean
  • Not paying attention during long conversations

Communication During Stages of Alzheimer’s and Dementia
According to the Alzheimer’s Association, communication can look very different during each stage of the disease. As your loved one progresses through the disease, keep these communication tips in mind:

Early Stage
In the early stage of Alzheimer’s disease, an individual will be able to participate in conversations and engage in normal social activities. However, the sufferer may notice some difficulties with word recall and be overwhelmed by excessive stimulation. If your loved one has been diagnosed with Alzheimer’s or dementia, it’s important not to make assumptions about the person’s ability to communicate because of a diagnosis. Instead, take time to listen and engage with the person, giving them the time they need to respond. At this stage, it’s appropriate to discuss which method of communication is most comfortable for them, such as face-to-face conversation, email, or phone calls.
Middle Stage
Moderate Alzheimer’s, or the middle stage of the disease, is the longest and can last for many years. As the disease progresses, communicating can get more challenging. It’s most important to engage with the person in one-on-one conversations while limiting distractions. Be sure to speak slowly and clearly while maintaining eye contact and physical touch, if appropriate. Be patient and give the individual plenty of time to respond.
Late Stage
In this stage of Alzheimer’s or dementia, an individual may fully rely on nonverbal communication, such as facial expressions, touch, and vocal sounds. When you’re communicating with a person in late-stage dementia, always approach the person from the front (Alzheimer’s can reduce a person’s peripheral vision). Identify yourself by name and relationship. Use touch, sight, and sounds as methods to communicate with people with dementia.

Phrases to Avoid
While the stages of dementia are good markers for when communication skills may decline, each individual is different. However, the words other people use to communicate to a person with Alzheimer’s or dementia can influence how successful the connection is. Practicing good communication techniques can help our loved ones feel heard and live well. According to the Alzheimer’s Society, these are a few phrases to avoid in conversation:

  • “Remember when?” This phrase can often evoke feelings of frustration, even if it’s meant to be encouraging and helpful. While talking about the past can bring up wonderful memories, try leading with a different phrase such as, “I remember when…” This way, your loved one won’t feel embarrassed if they can’t remember, or can join in on the conversation if they recall the memory.
  • “I’ve just told you that.” It’s normal to feel frustrated when a loved one has difficulty remembering words or thoughts you’ve just said. However, the most important part of communicating with someone suffering from dementia is to have patience and compassion. While it can be tempting to use this phrase, think about some tools that might help you when you’re feeling frustrated.
  • “What did you do this morning?” Open-ended questions can become challenging to answer as the individual moves through the stages of dementia. Instead, focus on the present situation as a conversation starter. One of the most common concerns is whether your loved one is eating well. Don’t ask, “Did you have breakfast this morning?” Stay in the present and ask, “Are you hungry now?”

Tips for Communicating
How you communicate with a person with dementia will change. However, your communication and connection don’t have to be less effective. As you learn to change the way you communicate based on your loved one’s needs, consider using these simple tips:
Be attentive — Your loved one may need time to recall words as they speak, especially in the middle and late stages of the disease. A good communicator will show they’re listening by using eye contact and friendly facial expressions.
Prioritize clarity — It’s important to speak clearly and avoid slurring words or mumbling when you’re speaking to someone with dementia. In addition, try to keep your hands away from your face when having a conversation. This can help your loved one understand what you’re saying and know how to respond.
Rephrase — It can be tempting to repeat what you’ve said if your loved one isn’t understanding. However, experts agree the best thing is to rephrase what you’re trying to communicate, using different words or gestures.
Offer choices — If your loved one begins to resist a basic daily task, like eating or showering, consider providing options to inspire a sense of independence. For example, you could say, “Would you like to eat now or after we take a walk?”
Avoid arguing — If your loved one says something you disagree with, avoid arguing with them. Instead, you might redirect the course of the conversation.

Providing Care at Maplewood Senior Living
Living with dementia or caring for someone who has it is difficult and almost always requires help. In addition to providing assistance with daily activities, Maplewood Senior Living communities offer support groups for both the individual and the caregiver to help navigate life after a diagnosis. To learn more about our offerings or to schedule a tour, please contact us.


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