How to Communicate with a Loved One with Dementia

If your loved one has been diagnosed with Alzheimer’s disease or another form of dementia, it can become increasingly more difficult to communicate effectively as the condition progresses. Watching your loved one’s communication skills slowly unravel can trigger a range of emotions, from frustration and anger to sadness and grief. Learning how to navigate through communication barriers can help you cope with the challenges ahead.

It’s important to recognize that your approach to communication may change as your loved one moves through the stages of dementia. Adapting your own verbal and nonverbal communication style may benefit your loved one by helping them convey their thoughts and needs.

Understanding Dementia’s Impact on Communication

Alzheimer’s disease and other forms of dementia can rob a person’s ability to communicate as the condition progresses. One of the most common symptoms of dementia is called “aphasia,” and it refers to the loss of ability to speak and understand speech. You might notice changes happening gradually over many months or years, or you could see a more rapid decline in their cognitive abilities. Your loved one might struggle to find the right words, change topics abruptly, or make unexpected substitutions for words or phrases. Over time, it may become increasingly difficult to follow a conversation or understand what is being communicated. 

Exploring ways to converse with someone with dementia can help you maintain a loving and supportive relationship with your loved one over time.

Communication Strategies by Stage

Early Stage

People in the early stages of dementia often have trouble concentrating on a conversation or losing their train of thought. It’s common to forget words when speaking or writing. You may also notice repetition in conversations, such as telling the same story again and again or asking a question repeatedly. At this stage, people with dementia are aware of these communication missteps and may try to gloss over their errors.

Be inclusive. It’s natural for a person with dementia to avoid social situations where they feel confused or uncomfortable. Look for ways to help your loved one stay engaged and interact with people every day. Doing so helps keep their communication skills sharper for longer. You can also help by using dementia conversation starters that tap into long-term memories, such as asking about their childhood or family memories.

Remove distractions. Making a few small adjustments can help prevent some common communication pitfalls. Whenever possible, create a calm and quiet environment where your loved one feels comfortable conversing. Make an effort to eliminate distractions like a TV or radio, and focus on one topic at a time during your conversation. Speak in plain language and avoid using figures of speech, which can be confusing for someone with dementia.

Moderate Stage

Communication deficits become noticeably worse at this stage. Your loved one may struggle to keep up with a conversation or follow the plot of a TV program, movie or book. Their vocabulary begins to narrow and they may become frustrated as they search for words. They may have trouble listening and following directions. Even if they hear what you’re saying, they may have difficulty following through on simple instructions or requests. You may see your loved one using gestures to express meanings more often when the words escape them.

Slow down. When you speak slowly and clearly, you may have greater success communicating with someone who has dementia. Clearly enunciate your words, and keep sentences, requests, and stories brief. Try to keep conversations as simple as possible by avoiding complicated inquiries in favor of questions with simple yes/no answers. 

Be supportive. Although many aspects of this journey are beyond your control, you do have control over setting the tone for communication. Instead of calling attention to the mistakes your loved one makes as they tell a story, simply let it go and focus on active listening. Your patience and encouragement may help them feel more confident expressing themselves. 

Severe Stage

At this stage, your loved one’s ability to communicate may decline rapidly, and their communication may be limited to basic conversation and instructions. They may forget people’s names and other important personal details. They may have moments of clarity followed by rambling or nonsensical talk.

Use body language. Pointing, gesturing, and other body language can be helpful in conveying a message as verbal language becomes more restricted. You can also engage the senses to help communicate through touch, taste, smell, sight and sound.

Focus on emotion. Emotions can be expressed even when the words don’t make sense. You can pick up on a loved one’s anxiety or frustration, and help reduce those feelings simply by being there and expressing that you care. A loving embrace or a warm smile sends a strong message without any words.

End Stage

Speaking and responding is highly limited at this stage. Your loved one may appear to be completely disengaged, with little to no comprehension of what’s happening in their world.

Offer reassurance. Simply being present and holding their hand while you visit can be comforting. Watch for body language for clues about creating a calm environment for your loved one.

Find Support for Your Loved One

Adopting new communication strategies while they go through the different stages of dementia can be a challenge. Walnut Place’s expert Memory Care program can give you and your loved one peace of mind. From our cozy and secure environment to music and art therapy, we’re passionate about our person-based approach to Memory Care. Schedule a visit today to tour our specialized Memory Care apartments.