How To Talk To Someone With Dementia: 15 Communication Tips

Medically reviewed by Melissa Guarnaccia, LCSW
Updated July 11, 2024by BetterHelp Editorial Team

When someone develops dementia, it affects much more than just their ability to remember names or past events. This condition can progressively affect many aspects of cognitive function, often leading to significant changes in behavior and communication skills too. Loved ones and caregivers often witness firsthand how the condition can impact daily life and relationships and may wonder how they can simplify and improve daily interactions.

Knowing how to communicate effectively with someone with dementia can be key to promoting positive interactions and minimizing distress for both parties. It tends to involve a delicate balance of listening, speaking clearly, and using clear body language in ways that align with their current abilities. From being patient and empathetic to choosing topics that avoid frustration, paying attention to different aspects of the interaction can help promote improved communication. These communication strategies are not about changing the person with dementia but adapting your methods to ensure they feel heard and respected.

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Caring for someone with dementia can affect mental health

How does dementia affect communication?

When a person has dementia, their communication skills usually decline. The condition can affect a person’s ability to use the correct words, making conversations challenging. They may struggle to convey their thoughts or understand what others are saying. Their speech may also become slower or less coherent over time, and they may have trouble with grammar and sentence structure, which can also make it harder to express themselves clearly.

As their ability to process information deteriorates, they might pause more often and lose their train of thought frequently. When communicating with someone with dementia, you may find that they repeat stories or words. This behavior is known as perseveration, and it requires patience and understanding from the listener. A person with dementia might also have trouble following complex conversations or instructions, potentially leading to confusion and frustration. In addition, changes in mood and behavior can affect how they engage in conversations, sometimes leading to withdrawal or agitation.

Furthermore, hearing and vision problems often accompany dementia, potentially complicating communication further. As a result, nonverbal messages such as facial expressions and physical gestures often become increasingly important as dementia progresses.

Communication tips for talking to someone with dementia

Communicating effectively with someone who has dementia requires understanding and compassion. Certain strategies may help make conversations go more smoothly, ensure the person with dementia feels heard, and decrease frustration for both parties.

  1. Communicate in a familiar environment

Communicating with someone with dementia often starts with the right surroundings. For example, excess noise or new elements in a person's environment may cause confusion and anxiety. Instead, speaking to the individual in a calm, quiet, and familiar place may help them feel more comfortable so you can interact more easily.

  1. Use simple sentences

Speak directly using straightforward language, as complex sentences or abstract concepts can confuse a person with dementia. For instance, instead of asking, "What would you like to have for your midday meal?" you could say, "Would you like soup for lunch?" Simplifying your speech may help reduce misunderstandings and keep the conversation flowing smoothly. Breaking down instructions into one step at a time can also be helpful, reducing cognitive load and making tasks easier to understand.

  1. Maintain eye contact

When conversing, look at the person steadily to signal your focus and presence. This visual connection can be comforting and may also help convey your message. In addition, maintaining eye contact can show respect and attentiveness, which may improve your emotional link. Eye contact can also help you gauge their emotional state and responsiveness, allowing you to adjust your approach accordingly.

An elderly woman in a brown dress sits on a couch and holds a coffee mug while talking to the younger woman sitting next to her.
Getty/Morsa Images

  1. Use facial expressions

As a person with dementia often experiences difficulty with spoken words, using expressive facial cues when speaking to them can become crucial. Smile to convey warmth and frown gently to show concern. This nonverbal communication can bridge gaps when words fail, providing emotional context and helping them interpret your words more accurately. Mirroring their expressions can also create a sense of empathy and understanding, reinforcing your connection.

  1. Focus on familiar conversation topics

Bringing up subjects that are meaningful and familiar to the person's past experiences can make conversations more engaging for them. For example, discussing a favorite childhood memory or a cherished hobby may invoke a sense of calm and happiness. Familiar topics from previous conversations or events can also stimulate their memory and make them feel more connected. Sharing photographs or music related to these topics might further enhance their engagement and enjoyment.

  1. Avoid correcting them or arguing

Correcting a person with dementia or engaging in arguments typically only leads to frustration for everyone. Instead, it can be more effective to validate their feelings and move the conversation along in a positive direction. Redirecting them gently can help maintain a pleasant atmosphere and avoid unnecessary stress. Using phrases like "I understand" or "That's interesting" may help validate their perspective without causing distress.

  1. Be mindful of body language

Ensure your posture and gestures are open and friendly. An outstretched hand or a gentle pat on the back can speak volumes to someone who has difficulty understanding speech or finding the right words. Other nonverbal cues, such as a nod or a smile, can also provide reassurance and support, helping them feel safe, understood, and valued. Maintaining a calm and relaxed demeanor could also help reduce any anxiety they might be feeling.

  1. Repeat or rephrase if necessary

If the person seems to not have understood your initial attempt to communicate, it's okay to repeat what you said or use different words for increased clarity. Remember to maintain a slightly slower pace than you normally would to allow them time to process. Rephrasing to simplify your language further or break down information into smaller, more manageable parts can be a useful approach to improve understanding, as can offering visual aids or written notes.

  1. Use names and titles

Refer to people by their names and titles to minimize confusion. Saying "Your daughter Julie" instead of just “Julie” or "she" can help provide context and clarity. This practice may not only support understanding but can also reinforce connections and relationships, making interactions more personal and meaningful. In addition, consistently using names and titles might help maintain a sense of familiarity and recognition.

  1. Be patient and reassuring

Allow them time to express their thoughts without rushing or interrupting them. Offer comfort and reassurance through both your words and tone to encourage a sense of security. Acting with patience can help promote a supportive environment where the individual can communicate safely, potentially reducing anxiety and promoting better interactions. Gentle physical contact, such as holding their hand, can further convey your support and understanding.

  1.  Encourage the person to communicate in their way

Depending on the individual, they may communicate best through gestures, drawings, or other nonverbal means. It’s generally best to encourage any form of expression, as it’s often essential for their well-being to be heard and understood in their own way. Being open to various forms of communication can help uncover new ways to connect and to have their needs and emotions understood. Incorporating tools like communication boards or apps can also promote more effective interactions.

  1. Adapt your tone

It can be helpful to modify your tone of voice to match the person's emotional state. A calm and soothing tone may help ease their distress if they seem anxious or upset. Conversely, a more upbeat tone may help improve the interaction if they're cheerful and engaged. Adapting your tone shows empathy and can make communication more effective.

  1. Be mindful of timing

Choose the right moment for conversations. People with dementia often have times of day when they are more alert and receptive. Interacting with them during these periods may help make communication smoother and more enjoyable. Avoid discussing important or complex topics when they seem tired or irritable, as this can lead to frustration.

  1. Incorporate humor

A light-hearted approach can sometimes ease tension and create a more positive interaction. Sharing a gentle joke or funny story may help lift their spirits and make the conversation more enjoyable. However, be sensitive to their mood and reactions; humor should only be used to enhance comfort and connection and should never be at their expense.

  1. Incorporate sensory stimuli

Using sensory stimuli can enrich communication. Familiar scents, textures, or sounds can evoke memories and emotions, making interactions more meaningful. For example, playing their favorite music or having a soft blanket they love at the ready can provide comfort and a sense of connection. Sensory experiences can also help bridge communication gaps and create a more engaging environment.

An elderly woman sits on a park bench on a sunny day  next to a younger woman in scrobs as they both smile at the camera.
Getty/Morsa Images
Caring for someone with dementia can affect mental health

Finding support as a caregiver

Caring for someone with dementia can be challenging, and it's not uncommon for caregivers and loved ones to experience stress and mental health challenges like depression or burnout. It can also be difficult to cope with feelings like frustration, sadness, and grief at witnessing the cognitive decline of a loved one. Your well-being is important too. Plus, research suggests that a caregiver’s ability to healthily manage stress may promote more positive outcomes for the person they’re caring for.

Therapy can be a supportive tool that may help a person manage mental health symptoms, receive emotional support, and learn healthy coping mechanisms for stress and grief. Online therapy platforms like BetterHelp may help provide a consistent connection to mental health resources regardless of location, which may be particularly beneficial for caregivers in remote or underserved areas or who don’t have time to travel to and from in-person appointments. In addition, the variety of available communication methods—including phone calls, video calls, and/or in-app messaging—means that the way you communicate with a licensed therapist can be tailored to your preferences and needs.

A growing body of research indicates that online therapy can be as effective as in-person care in many cases. One study suggests that online cognitive behavioral therapy (CBT) significantly improved mental health in caregivers of people with dementia at the stage of 26+ weeks. 

Takeaway

Dementia can severely affect an individual’s ability to communicate and interact with the world around them, and it may even cause them to withdraw at times due to frustration and confusion. Communicating effectively with an individual who has dementia can also be challenging and stressful for loved ones and caregivers. However, various strategies—such as focusing on body language, using familiar topics, and being patient—can be employed to improve interactions.
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