Why is it important to communicate effectively with someone with dementia?

It’s important that we recognise these changes and adapt what we do to make communication as effective as possible.

Minimise distraction

• turn the television off or move to a quieter area
• get the person’s attention
• does the person prefer to be called Mrs Jones? Elizabeth? Liz? Betty?
• Use their name at the beginning of the sentence to cue a person in

Think about your body position

• Can they see you?
• Get down to the person’s level, make eye contact. The visual field will shrink as the dementia progresses, so always approach from the person’s dominant side. You may need to get quite close before connection is made!

Speak clearly and calmly

• Simplify your sentences without speaking in childlike terms
• Use words the person uses. So if they call the toilet the ‘powder room’, so should you
• Avoid joining two sentences together by using ‘and’, ‘or’, ‘but’. Start a new sentence.

Think about your tone of voice

• Don’t speak to the person as you would to a child
• Your tone of voice will be affected if you are in a rush, cross, or fed up
• Remember it’s not always what you say, it’s how you say it!

Avoid too many questions

• Consider yes / no questions
• While it’s important to give people choices, sometimes too many choices will cause confusion.
• If you read out a list of choices at mealtimes, people often ‘choose’ the last on the list, as it’s the one they remember!
• It may be better to simply ask “would you like fish?” which requires a yes or no response or even better, show them the options.

Communicate without words

• Use exaggerate gestures. For example, show a person how to brush their teeth by doing the actions instead of explaining how to do it
• Use pictures to help with decision making
• Consider writing it down. Some people will be able to read, whereas others may not
• Use touch to reinforce spoken word

Understand how dementia affects communication and learn some useful tips and strategies for your conversations with people living with dementia as they progress through the stages of the disease.

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.

5 communication tips for conversations with people living with dementia (PDF)

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.

How does dementia affect communication?

Dementia affects how people express themselves and understand what is being communicated to them. For the person living 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 and
• Talking less than usual.

You may find that the person living with dementia has good days and bad days. This can depend on the person’s quality and amount of sleep, levels of stress and other medical conditions and needs that may require day-to-day care. This can result in conversations that feel onerous and frustrating, for both you and the person living with dementia.

How to approach communication with people living with dementia

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.
• The key to positive conversations with people living with dementia is respectful, sensitive and consistent communication.

Difficulties with communication can be discouraging for the person living with dementia and families, so consider creative ways to understand and connect with each other. In the video below, listen to what other caregivers have to say about caring for and communicating with people living with dementia.

The strategies discussed in the video above, as well as the tips listed below, are successful because they are based on a person-centred philosophy that views people living with dementia first and foremost as individuals, with unique attributes, personal values and history.

We also recommend learning as much as you can about dementia, its progression and how it can change the abilities of a person. As abilities change, you can learn to interpret the person’s messages by paying attention to both verbal and non-verbal cues.

Understand the symptoms associated with dementia and how to respond to these changes.

5 communication tips for conversations with people living with dementia

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. Chat face to face

• Avoid talking to the person if you’re behind them or where they can’t see you.
• Speak clearly, using short and simple sentences.
• Show as well as talk. Using actions can help give your words meaning.

4. Be flexible

• A person’s abilities can change from day to day, so take a few moments at the beginning of the conversation to assess how they’re doing.
• Look for changes in behaviour and body language that may tell how the person is feeling, especially if they may indicate discomfort. Adjust to accommodate.
• When the person is unable to communicate verbally, communicate through the senses, like touch.

5. Stay positive

• Be aware of your own tone and body language. Model the mood.
• Connect instead of correct. Ignore mistakes and give encouragement.
• When you feel overwhelmed, take a step back and exhale.

Take care of yourself too!

On the days when these tips don’t seem to help, remember that your presence is still felt by the person living with dementia. It’s not easy to be there for the person while also taking care of yourself at the same time. It’s important to find a healthy balance and ask for a hand when you need it!

For more information and support, contact your local Alzheimer Society at alzheimer.ca/Find. We are here to help.

Acknowledgements

The Alzheimer Society believes in a person-centred approach that centres meaningful engagement of people with lived experience of dementia. By doing so, we can better understand and serve the needs of the people who need us.

The information found on this page could not have been written without the contribution, guidance and support of the following people: Annette Berndt, Natalie Blain, Ngozi Iroanyah, Barbara Kielbiski, Barbara Tarrant and the Zigler family – Barbara, Cindy and Joel Zigler. The Alzheimer Society recognizes and thanks these kind people for sharing their unique experiences and insights as people with lived experience with dementia.

Appreciation is also extended to Smriti Shakdher, as well as the team at Black Belt Productions, for their contributions to the design and production of the resources featured on this page.

More useful links and resources

5 communication tips for conversations with people living with dementia (Document). Alzheimer Society, October 2021. When a person living with dementia is having trouble expressing themselves or understanding what is being communicated, try the tips in this one-page, print-friendly PDF to help you stay connected.

Communication (Document). Alzheimer Society, September 2018. This six-page, print-friendly information sheet goes over the importance of communication, how dementia affects communication, tips and strategies that could affect communication abilities and more.

10 communication tips (Document). Alzheimer Society. While this pocket sheet is intended for first responders who need to identify and communicate with a person living with dementia who may be lost, its helpful tips are useful for anyone looking to have a conversation with a person in the middle to late stages of dementia.

Person-centered language guidelines (Document). Alzheimer Society, November 2017. Whether you work to support people living with dementia, know someone who has dementia or just interested in using respectful, person-centred language, we encourage you to refer to and share this list of recommended terms to use in relation to dementia.

Communication strategies: Ways to maximize success when communicating with someone with dementia (Video). brainXchange, July 2012. This one-hour webinar goes over strategies to effectively communicate with a person living with dementia. Presented by Tracy Danylshen-Laycock, Behavioural Consultant for Seniors’ Health and Continuing Care with Saskatoon Health Region.

The power of language to create culture (Document). Carmen Bowman, MHS; Judah Ronch, PhD; and Galina Madjaroff, MA, 2013. This paper investigates how developing and using new language can positively affect the way seniors feel and think about themselves and function on a day-to-day basis.

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