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 in order 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 they're starting fewer conversations themselves. However, there are other ways to encourage communication:

  • speak clearly and slowly, using short sentences
  • make eye contact with the person when they're talking, asking questions, or having other conversations
  • don't make them respond quickly, because they may feel pressured if you try to speed up their answers
  • encourage the person to join in conversations with others where possible
  • don't speak on behalf of the person during discussions about their welfare or health issues, as this can make them feel invisible and they may not speak up for themselves in other situations
  • don't patronise the person you're looking after, or ridicule what they say
  • don't dismiss what the person you're looking after says if they don't answer your question or it seems out of context – instead, show that you've heard them and encourage them to say more about their answer
  • avoid asking the person to make complicated choices – keep it as simple as possible
  • you may find that you'll need to use other ways to communicate, and you may have to rephrase questions because the person can't answer in the way they used to

These are not the only hints that can help. Use the dementia carers' tips video wall (see below right) to find out how others have dealt with difficulties caring for a relative with dementia.

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. It also involves gestures, movement, facial expressions and other non-verbal means. Body language and physical contact become more significant when communication is difficult. There are several ways to make communication easier:

  • being patient and remaining calm can help the person communicate more easily
  • keep your tone of voice positive and friendly where possible, because tone is also a means of communication
  • don't stand too close to the person while talking as it can intimidate them – either be on the same level or lower than they are, which is less intimidating
  • patting or holding the person's hand while talking to them can help to 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 because of language or cultural differences.

Communication is a two-way process. Not only is it important that the person you're looking after is encouraged to use different skills to communicate, as a carer you will probably have to learn to 'listen' differently too.

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 help to improve communication between you and the person you're caring for.

Active listening

We all find it easier to understand someone else if we listen carefully. When communicating with the person you're looking after, use active listening skills:

  • use eye contact to look at the person, and encourage them to look at you when either of you are talking
  • try not to interrupt them, even if you think you know what they're saying
  • if possible, stop what you're doing so you can give the person your full attention while they speak
  • minimise 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
  • if you're not sure what's being said, repeat what you heard back to the person and ask if it's accurate, or ask them to repeat what they said
  • speak clearly
  • you may need to speak more slowly
  • 'listen' in a different way – shaking your head, turning away or murmuring are alternative ways of saying no or expressing disapproval
  • sometimes the person may feel unhappy that they can't communicate in the way they would like to – being able to express these feelings may be very important to them, and they may find it reassuring if you just listen rather than try to cheer them up
  • try not to finish the person's sentences – instead, look for clues in their body language, expression and tone to suggest words, and check with them to see whether you've understood them correctly

If you are looking after someone with dementia, you probably know them better than most people. These are only a few tips that you can build upon based on your own knowledge and experience.

Last reviewed: 13/06/2012

Next review due: 13/06/2014


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