Dementia guide

Communicating with people with dementia

Dementia is a progressive illness that over time will affect a person's ability to remember and understand basic everyday facts, such as names, dates and places. Dementia will gradually affect the way the person communicates. Their ability to present rational ideas and to reason clearly will change.

If you are looking after a person with dementia, you may find that as the illness progresses you'll have to start discussions to get the person to make conversation. This is common. Their ability to process information gets progressively weaker and their responses can become delayed.

Encouraging communication

Try to start conversations with the person you're looking after, especially if you notice that they're starting fewer conversations themselves. Other ways to encourage communication include:

  • speaking clearly and slowly, using short sentences
  • making eye contact with the person when they're talking, asking questions or having other conversations
  • giving them time to respond, because they may feel pressured if you try to speed up their answers
  • encouraging them to join in conversations with others where possible
  • letting them speak for themselves during discussions about their welfare or health issues, as they may not speak up for themselves in other situations
  • trying not patronise them, or ridiculing what they say
  • acknowledging what they have said, even if they don't answer your question, or what they say seems out of context – show that you've heard them and encourage them to say more about their answer
  • giving them simple choices – avoid creating complicated choices for them
  • using other ways to communicate – such as rephrasing questions because they can't answer in the way they used to

The Alzheimer's Society has several information sheets to help, including progression of dementia and communicating.

Body language and physical contact

Communication isn't just talking. Gestures, movement and facial expressions can all convey meaning or help you get a message across. Body language and physical contact become significant when speech is difficult for a person with dementia.

Communicating when someone has difficulty speaking or understanding can be made easier by:

  • being patient and remaining calm, which can help the person communicate more easily
  • keeping your tone of voice positive and friendly where possible
  • talking to them at a respectful distance to avoid intimidating them – being at the same level or lower than they are, for example, if they are sitting, can also help
  • patting or holding the person's hand while talking to them can reassure them and make you feel closer – watch their body language and listen to what they say to see whether they're comfortable with you doing this

It's important that you encourage the person to communicate what they want, however they can. Remember, we all find it frustrating when we can't communicate effectively, or are misunderstood.

Listening to and understanding someone with dementia

Communication is a two-way process. As a carer of someone with dementia, you will probably have to learn to "listen" more carefully.

You may need to be more aware of non-verbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking. The following tips may improve communication between you and the person you're caring for.

Active listening

When communicating with someone with dementia, "active listening" skills can help. These include:

  • using eye contact to look at the person, and encouraging them to look at you when either of you are talking
  • trying not to interrupt them, even if you think you know what they're saying
  • stopping what you're doing so you can give the person your full attention while they speak
  • minimising distractions that may get in the way of communication, such as the television or the radio playing too loudly, but always check if it's OK to do so
  • repeating what you heard back to the person and ask if it's accurate, or asking them to repeat what they said
  • "listening" in a different way – shaking your head, turning away or murmuring are alternative ways of saying no or expressing disapproval

Page last reviewed: 16/10/2014

Next review due: 16/10/2014

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