Losing the ability to communicate can be one of the most frustrating and difficult problems for people living with dementia, their families, and carers. There are many types of dementia, each affecting the brain in different ways. As the illness progresses a person with dementia experiences a gradual lessening of their ability to communicate. They find it more and more difficult to express themselves clearly and to understand what others say. It is also important to remember that every person with dementia is unique and difficulties in communicating thoughts and feelings are very individual.

Improving your communication skills will likely improve the quality of your relationship with your loved one and will help make caregiving less stressful. In fact, studies have shown that constant communication can not only improve quality of life, but can even slow down the progression of dementia.

Here are some tips from Dementia Auckland and Alzheimer’s New Zealand on how to effectively communication and emotionally connect with someone suffering from dementia

Be positive and relaxed

Your attitude and body language communicate your feelings and thoughts stronger than your words. Set a positive mood by entering a conversation with a calm, patient, and respectful manner. With some forms of dementia people may be aware of their memory loss, which can be difficult and frustrating for them. Try not to raise your voice higher or louder, instead, pitch your voice lower. By maintaining relaxed body language and a calm tone of voice, you can reassure the person with dementia that they are not a burden and that you appreciate their conversation. Try and respond with calmness and empathy, rather than anger or frustration.

Listen with your eyes, as well as your ears

Sometimes it may take a while for the person to reply to you, be patient, and give them time to respond. If you notice that they are struggling to answer, it’s okay to suggest words. Watch for non-verbal and body language cues and respond appropriately. When the dementia is severe, non-verbal communication may be the only option. Always strive to listen for the meaning and feelings that underlie the words.

Keep things simple

Someone with dementia may have difficulty juggling multiple conversations and thoughts at a time. Cover only one conversation and topic at a single time, this allows for greater mental engagement. State your message clearly. Use simple words that are clear and familiar to the person. Speak slowly, and in a reassuring tone. If they do not understand the first time, use the same wording to repeat your message or question. If the person still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns (he, she, they) or abbreviations.

Close ended questions

Ask simple, close ended questions that make it clear to the person the choices available to them. For example, ask, “Would you like to wear your white shirt or your blue shirt?” and if possible, show them choices—visual prompts and cues can help significantly. Ask one question at a time,  questions that require yes or no answers work best.

Use visual aids

If a person with dementia is struggling with words, visual aids are a great way to communicate your point, as well as invoke their memory recollection. Visual aids include body gestures or actions, as well as physical objects such as photographs, calendars, white boards, or handheld devices. Visual aids remain effective even in the mid to late stages of dementia.

Avoid distractions

People with dementia may be easily overwhelmed or distracted by external stimuli. Reducing background noise by turning off the TV or radio, shutting the door, or moving to quieter surroundings can help. A location with limited distractions will make it easier for them to be able to focus all their energy on the conversation. Before speaking make sure you have the person’s attention - direct hand and eye contact, makes it clear that you are speaking to them. If they are seated get down to their level. Try to ensure that only one person speaks at a time.

Engage their long-term memory

Although short-term memory fades, long-term memory remains intact for much longer, many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years ago. Remembering the good old days can be a soothing activity for a person with dementia as it is much easier for them to remember. Avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch instead, try asking general questions about the person’s past.

Redirect when the conversation gets tough

There will be good days and bad. When a bad day arises a person with dementia may become agitated or frustrated during conversation, try changing the subject or the environment. For example, ask them for help or suggest going for a walk. It is important to connect with the person on a feeling level, before you redirect such as, “I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”

Maintain your sense of humour.

Use humour whenever possible, though not at the person's expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.

*Dementia Auckland. 2021. Signs and symptoms of dementia. Retrieved from https://dementiaauckland.org.nz

*Alzheimers New Zealand. 2021. 10 warning signs. Retrieved from https://alzheimers.org.nz

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