How to Communicate with Someone Who Has Dementia

Scott Silknitter
By Scott SilknitterAugust 28, 2015

Lisa Ost-Beikmann, Director of Education for the National Association of Activity Professionals, and Scott Silknitter, founder of R.O.S. Therapy Systems, share how to communicate with someone who has dementia.

Learn more about which tools they use and tips to communicate with your loved one.

How Communication Changes in Someone with Dementia

Having covered the First Pillar of Activities and Engagement — Knowing Your Loved One — in our previous article for, we now move to the Second Pillar — Communicating with Your Loved One.

It can be challenging and unsettling when your loved one begins to have communication issues due to the progression of Alzheimer’s disease or another related dementia. The good thing is it doesn’t have to be that way. There are tools and tips which can be used to help.

Before getting to those, let us look at some of the communication challenges your loved one may have. As their Alzheimer’s progresses, your loved one might:

  • Have difficulty finding the “right” words
  • Make inappropriate comments
  • Become demanding and make unreasonable requests
  • Become frustrated easily
  • Become verbally abusive
  • May become very sarcastic
  • Have forgetfulness and difficulty with retrieval of learned information

Understanding some of those common changes in communication is a start. From there, we caregivers must be mindful of our communication style.

How to Communicate with Someone Who Has Dementia

To be an effective communicator, we must begin by accepting that the key to effective communication is the ability to listen attentively.

As a caregiver, you must use techniques that provide an open non-threatening environment for your loved one. Your listening behavior can either enhance and encourage communication or shut down communication altogether, and it is the foundation of the Second Pillar of Activities and Engagement – Communicating with Your Loved One.

Here are some basic tips for success:

Verbal Communication

  1. Use exact, short, positive phrases. If you have to repeat an instruction, say it the exact way you did the first time. If your message doesn’t get through after two attempts, add in tips from the nonverbal communication section below.
  2. Speak slowly, and give your loved one time to answer.
  3. Give one instruction at a time.
  4. Use a warm, gentle tone of voice, but talk to them as the adult they are.
  5. Use words and phrases that your loved one is familiar with.

Nonverbal Communication

Although it may seem that most communication happens verbally, research has shown that nonverbal communication has more of an impact. Nonverbal communication occurs through an individual’s body language.

Here are five key elements to consider:

  1. Facial Expressions: Be aware of what your facial expressions are conveying to your loved one.
  2. Eye Contact: Ensure that you have made eye contact with your loved one and that their attention is focused on you and what you are saying. Always approach your loved one from the front, and be at eye level when speaking to them.
  3. Gestures and Touch: Calmly use nonverbal signs such as pointing, waving, and other gestures in combination with your words. Give nonverbal praises such as smiles and head nods when appropriate.
  4. Tone of Voice: The inflection in your voice helps your loved one relate to what you are saying.
  5. Body Language: Be aware of the position of your hand and arms when talking to your loved one. It should be noted that when communicating with your loved one, be mindful that their body language may not fully tell you how they feel or what they are trying to express because of rigidity or slow movement. Your body language, however, will be read by your loved one.

We know that in stressful situations, it can be hard to remember all of the tips above. If you take one thing from this article, remember to always remain calm and approach your loved one with a relaxed demeanor. With this open and non-threatening approach, your loved one will know that you are there to listen, which is the foundation of the Second Pillar of Activities and Engagement.

Building on that foundation, you want to remember that there is no right or wrong way of completing an activity, so you must be guiding and flexible, but not controlling.

In our next piece, we will cover the Third Pillar of Activities and Engagement — Routines and Preferences. If you cannot wait and need help now, please check out one of our family caregiver books.

About the Authors

Lisa Ost-Beikmann, AC-BC, ADC, CDP, CAEd, CADDCT, is Director of Education for the National Association of Activity Professionals. Scott Silknitter, inventor, author, speaker, is the founder of R.O.S. Therapy Systems which began as a 2010 project to help his mother and father in a 25-year battle with Parkinson’s disease and dementia.

What communication changes have you seen in a loved one with dementia? Do you have any communication tips that you’d like to suggest? Share them with us in the comments below.

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