How to Talk to Someone With Dementia: 10 Expert Alzheimer’s Communication Strategies

The effects of dementia on the brain contribute to a decline in mental skills, including the following:

• Communication and cognition
• Memory and focus
• Language skills
• Visual perception
• Problem-solving skills

Symptoms of dementia begin when healthy neurons, or nerve cells, in the brain stop working with other brain cells and die, according to the National Institute of Neurological Disorders and Stroke.^[01] While losing neurons is more common as people age, people with dementia experience a severe loss of neurons. This extreme loss of neurons contributes to behavior and personality changes, a decrease in communication skills, and loss of emotional control. All of these things cause changes in how a person with dementia communicates.

Although dementia can manifest differently in different people, there are some tried and true tools to help improve conversations with your loved one. In general, it’s best to remain patient, clear, and understanding.

Here are 10 Alzheimer’s and dementia communication strategies to help you converse with your loved one.

Aim to find a quiet and comfortable spot to talk. Turn off the TV or any music playing in your home. If you’re in a café, store, or noisy place, consider finding a seat or area in a quiet corner away from the hustle and bustle.

Even simple distractions like these make conversation harder for everyone and can be especially overwhelming for someone with Alzheimer’s.

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It’s important to speak clearly, simply, and in complete sentences while using a calm and friendly voice to talk to someone with dementia.

Besides using your voice, try to communicate using your body. Incorporate subtle movements. Demonstrate your meaning with visual cues or gestures. For example, if you say, “Let’s go for a walk,” use an arm motion with your invitation. These extra cues can help a person with memory loss understand what you’re saying.

Read more:What Do Dementia Patients Think About?

Identifying yourself and others by name rather than by relationship is helpful, Gurung says. People with dementia may be more “present” in an earlier time in their life. This could be before you were their child or partner. They may be more likely to identify their spouse as their boyfriend or girlfriend, or may not remember a relationship from the last few years.

Rather than trying to reorient them to today, it can be better to say, “Hi, it’s me, Brenda,” instead of, “Hi Mom. It’s Brenda, your daughter.” Even with family members, you may find it more useful to call them by their preferred name rather than their title.

Someone with dementia may not be able to engage in the mental juggling needed to maintain a conversation with multiple threads. It’s best to keep conversations concise and simple.

Ask open-ended, observational questions. Avoid quizzing them or asking too much at once. If you’re looking through an old photo album, for example, you could say, “This is a beautiful dress. What do you think?” instead of, “Do you remember your wedding day?” Asking specifically about the dress keeps the conversation simple and direct.

Words aren’t the only powerful way to convey meaning and understanding: Your actions go a long way in communicating with someone with dementia. When dementia is advanced, you may find more success utilizing nonverbal communication.

One effective way to use nonverbal cues is to use eye contact and physical touch. Doing these steps in order helps establish that you want to communicate with your loved one in an affectionate, low-stakes manner:

1. Make eye contact.
2. Smile.
3. Hold their hand, or gently put your hand on their arm.
4. Make eye contact again.
5. Speak or sit quietly and be “in the moment.”

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It’s important to offer simple choices with visual cues. Asking questions like, “What would you like to wear?” can be overwhelming — it presents too many options. Instead, hold up two shirts and ask, “Would you like the shirt with the yellow flowers or the shirt with the blue stripes?” This simplifies the choice and makes it easier to communicate with a person who has dementia.

Don’t underestimate the power of communicating through smells, singing, and other creative methods. This Alzheimer’s communication strategy may be especially helpful with someone in the later stages of dementia. You might consider:

• Singing a favorite hymn or song
• Flipping through old photo albums
• Placing different smells in small dishes to experience together, such as freshly cut grass, ground cumin, or flowers

Read more:Memory Care Activities That Keep Seniors Active and Engaged

It’s best to give your loved one extra time to process what you say. If you ask a question, patiently wait for their response and avoid rushing an answer. Get comfortable with silence while your loved one is thinking.

When your loved one is struggling for a word, it can be tempting to jump in. But rather than helping, you may unintentionally derail their thought process, Gurung says.

Teepa Snow, a leading dementia care specialist, recommends asking yourself “So what?” when a loved one gets a fact wrong. If your mother thinks it’s Tuesday but it’s actually Friday, so what? Correcting a person with memory loss can make them feel frustrated, which can lead to unwanted behaviors, like aggression.^[02]

While dementia is a progressive disease that gradually worsens, people with dementia will have ups and downs just like anyone else. Sometimes, this can mean a loved one remembers a fact in the morning but forgets it by the afternoon. This doesn’t mean your loved one is “faking it” or being manipulative. It’s just the nature of the disease.

Enjoy the good times, and do your best during the difficult days. Friends and family members can provide emotional support
and care when needed.

“Alzheimer’s and other dementias are a hard journey,” says Gurung. “I always encourage loved ones and professionals to educate themselves to better support, empower, celebrate, and encourage people with these diseases. We’re in this together.”

Gurung advises families to continue learning using the following communication tools for dementia:

• What Is Validation? a video by Naomi Feil
• Creating Moments of Joy, a book by Jolene Brackey

If you’re seeing signs your loved one needs more care, our Senior Living Advisors can connect you with memory care communities and other resources nearby. Memory care communities specialize in Alzheimer’s communication strategies and caring for seniors who have dementia.