For more strategies, check out 10 Communication Tips. This pocket sheet for first responders has helpful tips that anyone can use when talking a person with dementia.
The importance of communication
Communication is a critical component of our life; 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.
How does dementia affect communication?
Dementia affects how people express themselves and understand what is being communicated to them. For the person with dementia, maintaining relationships can be a complex process, especially when verbal communication is affected. The following changes are common:
- Difficulty finding a word
- Creating new words for ones that are forgotten
- Repeating a word or phrase (perseveration)
- Difficulty organizing words into logical sentences
- Cursing or using other offensive language
- Reverting to the language that was first learned
- Talking less than usual
You may find that the person with dementia has good days and bad days - this can depend on the quality and amount of sleep, stress levels and other medical conditions.
How to approach communication
Respectful, sensitive, ongoing communication is the key to positive relationships. Here are ways to help you and the person with dementia understand each other better:
- Learn about dementia, its progression, and how it affects individuals. As abilities change, you can learn to interpret the person’s messages by paying attention to both verbal and non-verbal cues.
- Believe that communication is possible at all stages of dementia. What a person says or does and how a person behaves has meaning. Never lose sight of the person and what they are trying to tell you.
- Focus on the person’s abilities and skills. If the person’s speech has become hard to understand, using what you know about them and what you are feeling can help you interpret what they might be trying to say. Consider alternate ways of expression through art, music or other activities to maintain and enhance communication.
- Reassure and be positive. Use familiar things to create a sense of comfort and reassurance and encourage the person to communicate in ways that work for them. Laughter and humour are positive ways to help you get through difficult times.
- Meet the person where they are and accept their new reality. If the person’s perception of reality becomes confused, try to find creative ways around the situation rather than reacting negatively. Avoid contradicting the person or trying to convince them that what they believe is untrue or inaccurate.
Difficulties with communication can be discouraging for the person with dementia and families, so consider creative ways to understand and connect with each other. These strategies are successful because they are based on a person-centred philosophy, one that views people with dementia first and foremost as individuals, with unique attributes, personal values and history.
Tips for communicating with a person with dementia
Communicating well with someone who has dementia is not a skill that is learned overnight - it requires patience and practice. Remember to CONNECT not to CORRECT.
Before you speak
Reduce distractions in the environment. For example, lowering the volume of the TV or radio.
Make eye contact and use the person’s name when addressing them.
Make sure that the person is wearing a working hearing aid and/or clean glasses, if prescribed.
As some people have problems recognizing family and friends, you might want to introduce yourself and remind them who you are.
How to speak
Get close enough so they can see your facial expressions and any gestures you may use.
Speak clearly at a slightly slower pace and use short and simple sentences.
Use closed-ended questions which are focused and require a simple "yes" or "no" answer.
Show respect and patience. Avoid using childish talk or any demeaning language. Don’t talk about the person as if they are not there; try to include them in conversations with others.
How to listen
Listen carefully to what the person is saying and observe both verbal and non-verbal communications.
Be patient and try not to interrupt the person even if you think you know what they are saying. If the person is having difficulty finding the right words, you can offer a guess as long as they appear to want some help.
Make your communication a two-way process that engages the person with dementia. Involve them in the conversation.
If you don’t understand what is said, avoid making assumptions. Check back with them to see if you have understood what they mean.
Other ways of communicating
Use actions as well as words. For example, if it is time to go for a walk, point to the door or bring the person's coat or sweater to illustrate what you mean. Use body movements such as pointing or demonstrating an action to help the person understand what you are saying.
Humour can bring you closer, can release tension, and is good therapy. Laughing together over mistakes or misunderstandings can help.
If the person seems sad, encourage them to express their feelings, and show your care and affection to provide reassurance.
- Communication Strategies: Ways to Maximize Success when Communicating with Someone with Dementia, a webinar presented by brainXchange
- Communication, an information sheet by the Alzheimer Society of Canada
- Also be sure to check out our guidelines on language for person-centered care.