Which is the most appropriate statement question to use when speaking to a person with dementia?

Table of Contents Show

Before you communicate
Making sure the person is comfortable
Preparing to communicate with a person with dementia
Things to consider about conversation topics
Tips for listening to a person with dementia
Supporting the person to express themselves
How to communicate
Ways to communicate with a person with dementia
How to pace conversations
Things to consider about body language
What to communicate
Tips for asking questions
What to do if the person has difficulty understanding
Help Make Communication Easier
Be Direct, Specific, and Positive
Helping a Person Who Is Aware of Memory Loss
For More Information About Alzheimer's and Changes in Communication Skills

These tips apply to however the person usually communicates, for example speaking English or signing British Sign Language.

Every person’s experience of dementia is unique, so not every tip may be helpful to the person you care for. Use the tips that you feel will improve communication between you.

Before you communicate

Making sure the person is comfortable

Make sure you’re in a good place to communicate. Ideally it will be quiet and calm, with good lighting. Busy environments can make it especially difficult for a person with dementia to concentrate on the conversation, so turn off distractions such as the radio or TV.
If there is a time of day where the person is able to communicate more clearly, try to use this time to ask any questions or talk about anything you need to.
Make the most of ‘good’ days and find ways to adapt on more difficult ones.
Make sure any of the person’s other needs are met before you start – for example, ensuring they are not in pain or hungry.

Preparing to communicate with a person with dementia

Think about how you might feel if you struggled to communicate, and what would help.
Plan enough time to spend with the person. If you feel rushed or stressed, take some time to become calmer beforehand.
Think about previous conversations you have had with the person and what helped you to communicate well then.
If the person has begun to communicate using the first language they learned, and you do not speak it, consider arranging for family members or friends who also speak the language to be there with you. If the person prefers reading, try using translated written materials. A translation or interpretation app on a smart phone or tablet can translate between you if you don’t speak the same language. If you need an interpreter, speak to your local authority, the person’s care home, or an organisation such as the Institute of Translation and Interpreting.
Get the person’s full attention before you start.

Things to consider about conversation topics

Think about what you are going to talk about. It may be useful to have an idea for a particular topic ready.
If you are not sure what to talk about, you can use the person’s environment to help – anything that they can see, hear or touch might be of interest.

Listening

Tips for listening to a person with dementia

Listen carefully to what the person is saying. Offer encouragement both verbally and non-verbally, for example by making eye contact and nodding. This ‘active listening’ can help improve communication.
The person’s body language can show a lot about their emotions. The expression on their face and the way they hold themselves can give you clear signals about how they are feeling when they communicate.
If you haven’t fully understood what the person has said, ask them to repeat it. If you are still unclear, rephrase their answer to check your understanding of what they meant.
If the person with dementia has difficulty finding the right word or finishing a sentence, ask them to explain it in a different way. Listen and look out for clues. If they cannot find the word for a particular object, ask them to describe it instead.

Supporting the person to express themselves

Allow the person plenty of time to respond – it may take them longer to process the information and work out their response.
Try not to interrupt the person – even to help them find a word – as it can break the pattern of communication.
If the person is upset, let them express their feelings. Allow them the time that they need, and try not to dismiss their worries – sometimes the best thing to do is just listen, and show that you are there.

How to communicate

Ways to communicate with a person with dementia

Communicate clearly and calmly.
Use short, simple sentences.
Don’t talk to the person as you would to a child – be patient and have respect for them.
Try to communicate with the person in a conversational way, rather than asking question after question which may feel quite tiring or intimidating.
Include the person in conversations with others. It is important not to speak as though they are not there. Being included can help them to keep their sense of identity and know they are valued. It can also help them to feel less excluded or isolated.
If the person becomes tired easily, then short, regular conversations may be better.
Avoid speaking sharply or raising your voice.

How to pace conversations

Go at a slightly slower pace than usual if the person is struggling to follow you.
Allow time between sentences for the person to process the information and respond. These pauses might feel uncomfortable if they become quite long, but it is important to give the person time to respond.
Try to let the person complete their own sentences, and try not to be too quick to assume you know what they are trying to say.

Things to consider about body language

Stand or sit where the person can see and hear you as clearly as possible – usually this will be in front of them, and with your face well-lit. Try to be at eye-level with them, rather than standing over them.
Be as close to the person as is comfortable for you both, so that you can clearly hear each other, and make eye contact as you would with anyone.
Prompts can help, for instance pointing at a photo of someone or encouraging the person to hold and interact with an object you are talking about.
Try to make sure your body language is open and relaxed.

What to communicate

Tips for asking questions

Try to avoid asking too many questions, or asking complicated questions. The person may become frustrated or withdrawn if they can’t find the answer.
Try to stick to one idea at a time. Giving someone a choice is important, but too many options can be confusing and frustrating.
Phrase questions in a way that allows for a simple answer. For example, rather than asking someone what they would like to drink, ask if they would like tea or coffee. Questions with a ‘yes’ or ‘no’ answer are easier to answer.

What to do if the person has difficulty understanding

If the person doesn’t understand what you’re saying even after you repeat it, try saying it in a slightly different way instead.
If the person is finding it hard to understand, consider breaking down what you’re saying into smaller chunks so that it is more manageable.
Try to laugh together about misunderstandings and mistakes. Humour can help to relieve tension and bring you closer together. Make sure the person doesn’t feel you are laughing at them.

Read our blog post to find out seven things not to say to somebody living with dementia.

What not to say

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Communication is hard for people with Alzheimer’s disease because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they can’t.

The person with Alzheimer’s may have problems with:

Finding the right word or losing his or her train of thought when speaking
Understanding what words mean
Paying attention during long conversations
Remembering the steps in common activities, such as cooking a meal, paying bills, or getting dressed
Blocking out background noises from the radio, TV, or conversations
Frustration if communication isn’t working
Being very sensitive to touch and to the tone and loudness of voices

Also, Alzheimer’s disease causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, he or she might understand and use only the first language learned, such as Spanish.

Help Make Communication Easier

The first step is to understand that the disease causes changes in communication skills. The second step is to try some tips that may make communication easier:

Make eye contact and call the person by name.
Be aware of your tone, how loud your voice is, how you look at the person, and your body language.
Encourage a two-way conversation for as long as possible.
Use other methods besides speaking, such as gentle touching.
Try distracting the person if communication creates problems.

To encourage the person to communicate with you:

Show a warm, loving, matter-of-fact manner.
Hold the person’s hand while you talk.
Be open to the person’s concerns, even if he or she is hard to understand.
Let him or her make some decisions and stay involved.
Be patient with angry outbursts. Remember, it’s the illness “talking.”

To speak effectively with a person who has Alzheimer’s:

Offer simple, step-by-step instructions.
Repeat instructions and allow more time for a response. Try not to interrupt.
Don’t talk about the person as if he or she isn’t there.
Don’t talk to the person using “baby talk” or a “baby voice.”

Be Direct, Specific, and Positive

Here are some examples of what you can say:

“Let’s try this way,” instead of pointing out mistakes.
“Please do this,” instead of “Don’t do this.”
“Thanks for helping,” even if the results aren’t perfect.

You also can:

Ask questions that require a yes or no answer. For example, you could say, “Are you tired?” instead of “How do you feel?”
Limit the number of choices. For example, you could say, “Would you like a hamburger or chicken for dinner?” instead of “What would you like for dinner?”
Use different words if he or she doesn't understand the first time. For example, if you ask the person whether he or she is hungry and you don’t get a response, you could say, “Dinner is ready now. Let’s eat.”
Try not to say, “Don’t you remember?” or “I told you.”

If you become frustrated, take a timeout for yourself.

Helping a Person Who Is Aware of Memory Loss

Alzheimer’s disease is being diagnosed at earlier stages. This means that many people are aware of how the disease is affecting their memory. Here are tips on how to help someone who knows that he or she has memory problems:

Take time to listen. The person may want to talk about the changes he or she is noticing.
Be as sensitive as you can. Don't just correct the person every time he or she forgets something or says something odd. Try to understand that it's a struggle for the person to communicate.
Be patient when someone with Alzheimer's disease has trouble finding the right words or putting feelings into words.
Help the person find words to express thoughts and feelings. But be careful not to put words in the person’s mouth or “fill in the blanks” too quickly. For example, Mrs. D cried after forgetting her garden club meeting. She finally said, "I wish they stopped." Her daughter said, "You wish your friends had stopped by for you." Mrs. D nodded and repeated some of the words. Then Mrs. D said, "I want to go." Her daughter said, "You want to go to the garden club meeting." Again, Mrs. D nodded and repeated the words.
Be aware of nonverbal communication. As people lose the ability to talk clearly, they may rely on other ways to communicate their thoughts and feelings. For example, their facial expressions may show sadness, anger, or frustration. Grasping at their undergarments may tell you they need to use the bathroom.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Alzheimer's and Changes in Communication Skills

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center 800-438-4380

www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017