Communicating With a Person Who has Dementia
Alzheimer's disease and other dementias gradually diminish a person's ability to communicate. Communication with a person with Alzheimer's requires patience, understanding and good listening skills. The strategies below can help both you and the person with dementia understand each other better.
Changes in Communication
Changes in the ability to communicate are unique to each person with Alzheimer's. In the early stages of dementia, the person's communication may not seem very different or he or she might repeat stories or not be able to find a word. In addition to changes in the brain caused by Alzheimer's, a number of physical conditions and medications can affect a person's ability to communicate. Consult a doctor if you notice major changes
As the disease progresses, a caregiver may recognize other changes such as:
- Using familiar words repeatedly
- Inventing new words to describe familiar objects
- Easily losing his or her train of thought
- Reverting back to a native language
- Having difficulty organizing words logically
Speaking less often
Helping the person with Alzheimer’s communicate
People with Alzheimer's and other dementias have more difficulty expressing thoughts and emotions; they also have more trouble understanding others. Here are some ways to help the person with Alzheimer's communicate:
Be patient and supportive.
Let the person know you're listening and trying to understand. Show the person that you care about what he or she is saying and be careful not to interrupt.
Offer comfort and reassurance.
If he or she is having trouble communicating, let the person know that it's okay. Encourage the person to continue to explain his or her thoughts.
Avoid criticizing or correcting.
Don't tell the person what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said if it helps to clarify the thought.
If the person says something you don't agree with, let it be. Arguing usually only makes things worse — often heightening the level of agitation for the person with dementia.
Offer a guess.
If the person uses the wrong word or cannot find a word, try guessing the right one. If you understand what the person means, you may not need to give the correct word. Be careful not to cause unnecessary frustration.
Encourage unspoken communication.
If you don't understand what is being said, ask the person to point or gesture.
Find a place that's quiet. The surroundings should support the person's ability to focus on his or her thoughts.
Focus on feelings, not facts.
Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.
Best Ways for You to Communicate
While a person with later-stage Alzheimer's may not always respond, he or she still requires and benefits from continued communication. Ongoing communication is important, no matter how difficult it may become or how confused the person with Alzheimer's or dementia may appear. When communicating with a person with dementia, it's especially important to choose your words carefully.
- Identify yourself - Approach the person from the front and say who you are. Keep good eye contact; if the person is seated or reclined, go down to that level.
- Call the person by name - It helps orient the person and gets his or her attention.
Ongoing communication is important, no matter how difficult it may
become or how confused the person with Alzheimer's or dementia may
appear. Use short, simple words and sentences.
Lengthy requests or stories can be overwhelming. Ask one question at a time.
Speak slowly and distinctively
Be aware of speed and clarity. Use a gentle and relaxed tone — a lower pitch is more calming.
- Patiently wait for a response - The person may need extra time to process what you said.
Repeat information or questions as needed.
If the person doesn't respond, wait a moment. Then ask again.
Turn questions into answers.
Provide the solution rather than the question. For example, say "The bathroom is right here," instead of asking, "Do you need to use the bathroom?"
Avoid confusing and vague statements.
If you tell the person to "Hop in!" he or she may interpret your instructions literally. Instead, describe the action directly: "Please come here. Your shower is ready." Instead of using "it" or "that," name the object or place. For example rather than "Here it is" say "Here is your hat."
Turn negatives into positives.
Instead of saying, "Don't go there," say, "Let's go here."
Give visual cues.
To help demonstrate the task, point or touch the item you want the individual to use or begin the task for the person.
Reminiscing may be healthy, but avoid asking, "Do you remember when?"
Write things down.
Try using written notes as reminders if the person is able to understand them.
Treat the person with dignity and respect.
Avoid talking down to the person or talking as if he or she isn't there.
Convey an easygoing manner.
Be aware of your feelings and attitude — you may be communicating through your tone of voice. Use positive, friendly facial expressions and nonverbal communication. For communication tips from other caregivers, join ALZConnected, our message boards and online support community. Every day, caregivers like you share new ideas and encourage one another.
Visit the Alzheimer’s Organization website at www.alz.org or call 1-800-272-3900
Reprinted with permission of the Alzheimer’s Organization, April, 2013.