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An early sign that someone's language is being affected by dementia is that they can't find the right words - particularly the names of objects. They may substitute an incorrect word, or they may not find any word at all.

There may come a time when the person can hardly communicate in language at all. Not only will they be unable to find the words of objects, they may even forget your name. People with dementia often confuse the generations – mistaking their wife for their mother, for example. This may be very distressing for you as the caregiver, but it's a natural aspect of their memory loss.

The person you are caring for may be trying to interpret a world that no longer makes sense to them because their brain is interpreting information incorrectly. Sometimes you and the person with dementia will misinterpret each other's attempts at communication. These misunderstandings can be distressing, and you may need some support.

Difficulties with communication can be distressing and frustrating for the person with dementia and for you as a caregiver. But there are lots of ways to help make sure that you understand each other.

Listening skills and Dementia

• Try to listen carefully to what the person is saying and give them plenty of encouragement.
• If they have difficulty finding the right word or finishing a sentence, ask them to explain in a different way. Listen out for clues.
• If their speech is hard to understand, use what you know about them to interpret what they might be trying to say. But always check back with them to see if you are right – it’s infuriating to have your sentence finished incorrectly by someone else!
• If the other person is feeling sad, let them express their feelings without trying to ‘jolly them along’. Sometimes the best thing to do is to just listen, and show them that you care.

Getting their attention and Dementia

• Try to catch and hold the attention of the person before you start to communicate.
• Make sure they can see you clearly.
• Make eye contact. This will help them focus on you.
• Try to minimize competing noises, such as the radio, TV, or other people’s conversations.

Using body language and Dementia

A person with dementia will read your body language. Agitated movements or a tense facial expression may upset them and can make communication more difficult.

• Be calm and still while you communicate. This shows the person that you are giving them your full attention, and that you have time for them.
• Try to find ways to relax so that your body language communicates confidence and reassurance.
• If words fail the person, pick up cues from their body language. The expression on their face and the way they hold themselves and move about can give you clear signals about how they are feeling.

Speaking clearly and Dementia

• As the dementia progresses, the person will become less able to start a conversation, so you may have to start taking the initiative.
• Speak clearly and calmly. Avoid speaking sharply or raising your voice as this may distress the person, even if they can’t follow the sense of your words.
• Use simple, short sentences.
• Processing information will take the person longer than it used to – so allow them enough time. If you try to hurry them, they may feel pressured.
• Avoid asking direct questions. People with dementia can become frustrated if they can’t find the answer, and they may respond with irritation or even aggression. If you have to, ask questions one at a time and phrase them in a way that allows for a ‘yes’ or ‘no’ answer.
• Try not to ask the person to make complicated decisions. Too many choices can be confusing and frustrating.
• If the person doesn’t understand what you are saying, try getting the message across in a different way rather than simply repeating the same thing.
• Humor can help to bring you closer together and is a great pressure valve. Try to laugh together about misunderstandings and mistakes – it can help.

continue:  Communicating with the Dementia Patient

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Reviewed: 03/2006