Overview

How does dementia make communication difficult?

A person with early-stage dementia or Alzheimer's may have trouble finding the right words.

As dementia gets worse, so do problems with words and thinking. A person may say things that don't make sense. They may also have trouble knowing what others are saying.

When dementia is severe, a person can't communicate with words and may not be able to answer yes/no questions with gestures. When this is the case, it's a person's behavior that hints at their needs and feelings. You may find that the best ways to communicate are with your presence, touch, and tone of voice.

Communicating with a person who has dementia

Communicating with a person who has Alzheimer's disease or another dementia can be very challenging. Changing your approach to the way you communicate may be helpful.

• Make sure the person does not have a hearing or vision problem. Sometimes a person may not respond to you because they cannot hear you. Not being able to see well may make the person more confused, agitated, or withdrawn. If you suspect a problem, have a health professional evaluate the person's hearing and vision.
• Don't argue. Offer reassurance, and try to distract the person or focus their attention on something else. Do not confront the person about their denial of the disease.
• Use short, simple, familiar words and sentences. Present only one idea at a time. And avoid talking about abstract concepts.
• Explain your actions. Break tasks and instructions into clear, simple steps, offered one step at a time.
• Pay attention to your tone of voice. Be calm and supportive. A person with dementia is still aware of emotions and may become upset upon sensing anger or irritation in your voice.
• Maintain eye contact and use touch to reassure. This shows that you are listening. Touch may be better understood than words. Holding the person's hand or putting an arm around their shoulder may get through when nothing else can.
• Pay attention to the person's tone of voice and gestures. This can give you clues as to what the person is feeling. Sometimes the emotion is more important than what is said.
• Continue to treat the person with dignity and respect.
• Allow choices in daily activities. Let the person select their clothing, activities, and foods. But too many choices can be overwhelming. Offer a choice of 2 to 3 options, not the whole range of possibilities.