Communicating with people who have dementia

If you have Alzheimer’s disease or another dementia disorder, it can eventually become harder to take part in conversations with others.

For example, it may be difficult:

• to understand what is being said
• to find the words to say what you want to say.

People with dementia often become insecure and frustrated in situations where they cannot understand what is being said or cannot express what they want to. It may be obvious that the person with dementia wants to tell you something, but it can be difficult – and sometimes impossible – for relatives to work out what it is.

As the dementia disorder becomes more serious, communication problems worsen. In the end, the person with dementia may not be able to speak at all. It is therefore important that conversation and time together are adapted to the individual person and situation.

Below you will find practical advice that can make conversations with a person with dementia more balanced and less frustrating for both parties.

Calmness and reassurance

If you want to have the best possible conversation, you should be in a calm environment with a relaxed atmosphere. Tranquillity and a good atmosphere mean that people with dementia can feel safe. Turn off sounds that have nothing to do with your conversation, for example television and radio. Try to avoid disturbances. If necessary, hang a sign on the door saying you do not want to be disturbed for the next hour.

When you have a dementia disorder, you also find it difficult to take part in conversations with more than one person at a time. A person with dementia takes longer to understand and respond to what is being said. Therefore, it is necessary to have breaks in the conversation and to speak one at a time.

When you speak

There are several things you can do so you speak in a way that is easier to understand for people with dementia.

For example, try to:

• Speak slowly and clearly.
• Use short sentences.
• Give one message at a time.
• Repeat sentences if necessary.
• Be aware of the questions which you ask the person with dementia. Open questions such as: “What did you do yesterday?” can be very difficult for a person with dementia to answer. Instead, ask questions that can be answered with a yes/no or give a few options for answering such as: “Do you want to wear the black or the brown jacket?”
• Avoid irony, sarcasm and figurative language. People with dementia find it easiest to understand specific messages that do not need to be interpreted.
• Use the name of the person with dementia where it fits the conversation. This creates reassurance and maintains attention.
• Use names instead of pronouns. Say: ”Jytte will come and help you” instead of ”She will come and help you.”
• Be aware of whether there is contact between you – re-establish contact again and again.
• Be predictable. Say what you are going to do before you do it. For example, say what you are going to do next before you do it: “I’m going to get the coffee now.”
• Use the things that are important for the person with dementia as a starting point.
• Listen to what is being said – and also to what is not being said.

Body language is important

When words and their meaning disappear, body language becomes even more important than usual. The way you communicate with your body becomes very important for having a conversation with a person with dementia. Here are seven tips for body language when communicating with a person with dementia:

• Make eye contact before you start talking.
• Make sure you are both standing or sitting so you are at eye level.
• You can create a feeling of reassurance if you touch the person with dementia. However, touching can also cause insecurity. Only touch the person if he or she is comfortable with it and take notice of how close you can be to each other during the conversation.
• Show what you are talking about. Either by using your hands to point or by showing the object you are talking about. For example, hold the coffee cup up when you ask if you should pour more coffee.
• Be aware of your facial expressions and your tone of voice. If you smile while your voice sounds grumpy, the person with dementia may become very confused and frustrated. In the same way, it is very confusing if you shake your head while saying “yes”.
• The body language of the person with dementias also becomes more important as the ability to speak declines. Keep an eye on the person’s body language, facial expressions and eyes.
• Be aware of how you move. If you walk in at a brisk pace and go straight towards the person with dementia, you may be perceived as threatening. Walk steadily and be predictable.

More information: Good advice for relatives of people with dementia

Help the person with dementia on their way

In addition to making your own communication easier to understand for a person with dementia, you can also do something to help them with their communication.

• Take breaks and be patient so that the person with dementia has a chance to answer.
• Suggest words that are missing – but be careful not to take over the conversation.
• Repeat the last words that were said.
• Repeat points and ask additional questions.
• Summarise regularly. This shows that you are attentive, and you can also correct misunderstandings.
• Be honest if you have lost the thread of what the person is saying.

Acknowledge and respect what the person with dementia perceives as problems – even if you do not agree. Acknowledgement is not the same as just agreeing with them. Listen and acknowledge the dissatisfaction instead of denying the perceived problems. The person with dementia cannot change their position, but you can.