Communicating With A Dementia Patient

By Our Family Home Care

Communication is how we maintain our relationships, so when dementia robs the ability to speak and understand it can strain the bonds between caregivers and their loved ones. If two people can’t talk, how do they get along? Here we will define and understand the problem, and explain some solutions. Planning a strategy to communicate is crucial in maintaining personal connections, and in becoming a better caregiver.

As Alzheimer’s disease and other related dementias destroy brain cells, a significant symptom, known as “aphasia,” is losing the ability to speak and understand speech. Aphasia worsens as the disease progresses. It becomes harder to remember the right words and process what others are saying. Difficulty speaking is one of the first noticeable symptoms in people with dementia, particularly those with Fronto Temporal dementia.

Dementia takes years to advance over stages, the symptoms worsening in each subsequent stage. In the early stages, someone can carry on normal conversations but will simply forget a word or use the wrong words. Resuming a conversation after an interruption becomes difficult. These communication hiccups happen all the time to most people, but dementia affects the brain so that language problems become more noticeable. 

Loss of Communication Happens In Stages of the Disease

Early Dementia / Alzheimer’s - Some difficulty concentrating and following conversation; difficulty finding the right words when speaking or writing; losing train of thought when speaking; repeating oneself. Usually, the person with dementia is aware of these problems and may try to hide or overcompensate for them.

Moderate or mid-stage Dementia / Alzheimer’s - Difficulty following along with group and one-on-one conversations; losing train of thought when speaking; increased difficulty finding the right words when speaking or writing; loss of vocabulary, like proper nouns and slang terms; substituting words that sound the same or inventing new words; difficulty following storylines in books, TV shows, or movies; difficulty following directions; poor recall when telling others about recent events; increased use of gestures to communicate.

Severe or late-stage dementia / Alzheimer’s - Inability to follow along with anything other than simple conversations and instructions; increased loss of vocabulary, including personal information and loved ones’ names; inability to follow storylines in books, TV shows, or movies; tendency to talk about nothing, rambling, or babbling.

End-stage Dementia / Alzheimer’s - Inability to speak or otherwise respond verbally; difficulty or inability to understand when spoken to; all communication may be non-verbal.

Ways To Help Communicate

  • Being clear and concise in what you say. Use short sentences and short words.
  • Use closed rather than open questions. For example, “Do you want to go for a walk?” rather than “What would you like to do this afternoon?” 
  • Offer simple choices. For example, “Boots or trainers”?
  • Reinforce a message with a visual prompt such as a photograph or video. 
  • Always introduce yourself when you first see them. 
  • Avoid using a childlike tone of voice. You may witness the deterioration in mind and body so the natural reaction is to treat them as a vulnerable minor. They are adults with life experience, so it is crucial to maintain respect.
  • Make sure the quality of conversation does not diminish. They are the same person so continue to talk about subjects that you would normally talk to each other about.  

another way to communicate with someone with dementia is music, something we spoke about recently on the website in our previous Ourticle - Music & Dementia

We would like to thank the two companies which helped supply information for this Ourticle and we would encourage you to check out their sites to read up more on communicating with a Dementia patient or to learn more about Dementia too.

MedicAlert - The MedicAlert Foundation first launched in Turlock, California, in 1956, before coming to the UK over 55 years ago. As the pioneers of medical IDs, we remain the only charity provider of life-saving medical ID services worldwide.

Dementia Care Central - DementiaCareCentral is a resource center for dementia caregivers, and more! There is already a lot of information about dementia on the Internet, but it’s not always well organized and can be overwhelming.


All information provided within the ourticle is correct at time of publishing, all answers and suggestions provided by the guest are all thier personal views.