Communicating with People Living with Dementia

To have the most success during activities and conversations with people with dementia, care partners will need to adjust their style of communication so it is easier for the person with dementia to understand and follow the conversation.  Here are some tips that will ensure success.

Consider this

Sometimes it is hard to remember that our loved one with dementia is struggling each day to communicate with us.  Here are some points to remember about communication and dementia:

• The person is trying very hard to make sense of what is going on in the environment.
•  The person may be embarrassed, scared or frustrated about not understanding conversations or directions.
•  The person is not forgetting information on purpose or trying to annoy you.
•  The person may not be aware of one’s own actions or behaviors.
•  The person with dementia is an adult with a lifetime of experiences and adult desires and needs.  We should always treat people like adults, not children.

Talking Tips

Here are some tips for communicating with someone with dementia:

• Find a quiet space with a small group of people.
• Be calm and positive.
• Approach them slowly from the front.
• Make eye contact
• Be okay with silence.
• Allow time for a person to think of words rather than jumping in to suggest words for them
• Use touch to help initiate an activity.  For example, place your hand over the other person’s hand, pick up a pitcher of juice and assist them in pouring the juice into a cup.
• Use touch to provide comfort or direction.
• Try and validate their thoughts, feelings and concerns.  Validating does not mean agreeing.  It means saying things like, “That sounds like it was very scary,” or “That would make me mad too.”
• Try and go with their version of events and validate the emotions behind the content of what they are saying.  For example, they may believe their child is coming to see them later in the day, and you know their child is not.  Ask questions about their child instead of arguing with them that their child is not coming.  Tell a story about your own child and then try and redirect to an activity that meets the emotional need.  Maybe help them write a letter to their child.
• Speak with simple, clear, brief and direct words.
• Use pictures, writings and gestures to convey meaning.
• Give one direction at a time and demonstrate exactly what you would like the person to do.
• Ask yes/no questions, such as, “Would you like to set the table with me?”
• Give choices, such as, “Would you like to wear the red shirt or the blue shirt?
• Never quiz, argue with or confront a person with dementia.

Starting a Conversation

• Say hello and state your name (if the person has trouble with names.)
• Notice something about them, such as saying you like their shirt or that someone told you the person likes sailing.
• Ask a question about what you noticed, such as, “This color blue in your shirt is my favorite.  Do you have a favorite color?” or, “I don’t know how to sail, is it hard to learn?”  The key here is to ask a question that is interesting to them, but not one they need to use recall to answer.  For example, you might not want to say “I heard you like sailing.  When did you start sailing?” because that question requires recall.
• They may answer questions with short words but not ask you questions back.  That is okay!  You can continue to ask simple questions or tell them a story from your life or about something you have read about the topic you are talking about.

Aids to Conversation

Some people with dementia may not talk much, or they may have one-word responses. This is fine, and yet it can feel uncomfortable to not have a conversation that goes back and forth.  Also, some people have a hard time paying attention to a conversation at all.  So, look for aids to conversation in your environment to help you:

• Talk about a piece of art on the wall.  “I love the color in this painting.  What colors do you see in this painting?  What do you think that dog is looking at?”  Asking them questions about art is a great way to engage in conversation because the art prompts words, images and memories for the person.  Take their answers as they come.  Do not correct the person, whatever they say about the artwork is fine.
• Coffee table books with photos of topics they love are great aids to conversation and connection.