Dementia and Communication

Dementia and Communication

Losing the ability to communicate can be a frustrating – at times heartbreaking – experience for people living with dementia, along with their families and friends.

As the condition progresses and impacts the brain’s functioning, the person may find it increasingly difficult to express themselves and understand what others are saying. While each person is unique, here are some of the common changes you might notice in yourself or your loved one:

  • Difficulty finding the right word
  • Being able to speak fluently, but not make sense
  • Not being able to understand what someone is saying
  • Decrease in reading and writing skills
  • Repeating familiar words
  • Difficulty with appropriately expression emotions
  • Describing familiar objects rather than calling them by their name
  • Losing a train of thought
  • Difficulty organising words in a sentence
  • Reverting to a person’s native language
  • Speaking less often
  • Using gestures rather than speaking

Tips on how to communicate

Communicating with someone living with dementia is an important part of nurturing your relationship, but it can require patience and empathy. Here are some tips on how to communicate effectively in everyday life.

Listen carefully and pay attention to body language

Did you know that communication is 55 percent body language (including facial expressions), 38 percent tone of voice, and only 7 percent the actual words we say? When speaking to someone with dementia, keep in mind that your body and facial cues, such as frowning, sighing or smiling, can say a lot.

On the flip side, pay attention to their body language: their facial expression and gestures can reveal a lot about what they are feeling, even if you can’t understand their words. Practice ‘active listening’ by paying close attention to what they are saying and offering encouragement such as making eye contact and nodding.

Be caring and respectful

People still have feelings even if they don’t understand what is being said. It’s important to treat everyone with dignity and respect, and communicate in a way that upholds their self-esteem. This might mean:

  • When appropriate, using touch to communicate friendliness and affection
  • Remaining calm and talking in a gentle, matter-of-fact way
  • Not arguing, ordering someone around or telling someone what to do
  • Not being condescending and talking to someone as if they are a child
  • Including people in conversation – don’t talk about someone in front of them as if they are not there

Think about your environment

Busy spaces make it difficult for a person with dementia to concentrate on a conversation. If you can, plan to chat in a quiet environment (e.g. a living room), turn off distractions such as the TV or radio, and make sure you have enough time to talk without being rushed.

It’s also easier for the person to understand what you’re saying if they can see you, so try to stay in their line of vision (usually this will mean sitting in front of them) with your face well-lit. Make sure you are eye level with the person, rather than standing over them. Be as close as is appropriate, so you can hear each other and make good eye contact.

Tips for conversation

Are you unsure what to talk about? Here are some tips on what to say when chatting with someone who is living with dementia.

  • Don’t ask too many questions. Direct questions rely on having a good memory, which can make people with dementia feel uncomfortable and frustrated. Instead, talk in a conversational way, and share what has been happening in your life too.
  • Think about topics to talk about beforehand. If you are unsure what to talk about, it may be useful to have some ideas for conversation prepared. Think about things in your environment that can be a prompt (e.g. a photograph), or what the person enjoys doing.
  • Connect instead of correct. If you can’t understand what someone is saying, try rephrasing their answer to check what they meant, or ask them to explain it in a different way. Ignore mistakes and give plenty of encouragement.
  • Pauses are fine. Don’t feel like you need to fill in silent gaps! The person may be taking time to think of the right way to respond, and if you interrupt it can break their train of thought. Allow time between sentences for them to process the information.
  • Speak plainly, but don’t be condescending. Using short and simple sentences can be helpful, but don’t talk down to the person as if they are a child. Orienting phrases can also be helpful, (e.g. ‘your daughter Lisa)’. A short conversation may also be needed if the person becomes tired easily.
  • Don’t lose your sense of humour. It’s okay to laugh together about misunderstandings and mistakes, as it can lighten the mood and create a bond between you (though make sure the person doesn’t feel like you are laughing at them).

Communicating in another language

Sometimes, a person with dementia may revert back to communicating in the first language they learned. If you don’t speak this language, it might be a good idea to find family or friends who speak the same language so you can still communicate together. You may also want to look into services that offer support coordinators and carers who speak your loved one’s language. Dementia Caring’s multicultural team offers staff who can speak a range of languages. Please get in touch to discuss your situation.