The Big Picture
A person living with dementia may lose some language skills over time. As this happens, the person may depend more on your tone, facial expression, movements, and other messages that do not use words.
Respect and patience matter throughout the conversation. The way you speak, listen, move, and respond can support the person’s dignity and sense of identity.
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Start Here If You’re Overwhelmed
Focus on these core ideas:
- Use clear, calm speech and short, simple sentences.
- Give the person enough time to understand information and respond.
- Reduce distractions and make sure you have the person’s attention before speaking.
- Use active listening by concentrating on the person’s words, feelings, and nonverbal cues.
- Match your words with calm, respectful body language.
- Avoid overwhelming the person with too many questions, choices, or complicated explanations.
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Course Notes: Key Ideas You Need to Know
Words Are Only Part of Communication
Both spoken messages and nonverbal communication matter when communicating with a person living with dementia.
Nonverbal communication means sending messages without words. Facial expressions, movements, posture, and other cues can affect how the person understands the interaction.
As language skills decrease, the person may rely more on these nonverbal cues. This makes your tone, facial expression, and movements especially important.
Before You Start Speaking
Prepare the conversation so the person has a better chance of focusing on you.
- If you feel rushed or stressed, try to calm yourself first when possible.
- Think about what you want to discuss or accomplish.
- Make sure you have the person’s full attention.
- Position yourself where the person can see you clearly.
- Try to make eye contact to help the person focus.
- Reduce competing sounds such as television, radio, or other conversations.
Speak Clearly and Give Enough Time
Speak clearly and calmly. Use short, simple sentences.
Slow your speaking pace slightly. Leave enough time between sentences for the person to process what you said and respond.
The pause might feel long to you. Giving that extra time supports the person’s ability to communicate.
Avoid sharp speech or raising your voice. These behaviours may cause distress .
Keep Communication Respectful
Do not speak about a person with dementia as though they are not present. Do not speak to the person as though they are a young child.
Show patience and respect.
Keep your communication positive when you speak with the person.
Humour may sometimes reduce pressure and help people feel closer. Sharing a laugh over a misunderstanding or mistake may help when it fits the situation.
Include the Person in Conversations
Try to include the person when other people are talking.
You might need to adjust how you phrase things so the conversation is easier to follow. Social inclusion can help the person maintain a sense of identity and reduce feelings of isolation or exclusion.
Ask Questions Carefully
Too many direct questions may cause frustration when the person struggles to find an answer.
If you need to ask questions:
- ask one question at a time
- keep the wording simple
- use a question that allows a yes or no answer when appropriate
Closed-ended questions limit the response to one word or a few words. A yes-or-no question is one example.
Keep Choices Manageable
Choice remains important when the person can manage it.
Too many options may become confusing or frustrating. Avoid asking the person to make complicated decisions.
Change Your Approach When the Message Is Not Understood
If the person does not understand you, do not keep repeating the same message in the same way.
Try another approach. You might:
- explain the idea using different words
- divide a complicated explanation into smaller parts
- use written words
- use objects to help communicate the message
Respond to Confusion Without Directly Contradicting
As dementia progresses, a person may become confused about what is true.
When the person says something you know is incorrect, try to guide the conversation around the subject instead of directly contradicting the person.
Pay attention to the meaning or feelings behind what the person is saying.
Listen for Words, Feelings, and Clues
Listening involves more than hearing words.
Active listening means listening without judging, concentrating fully on what the person says, and paying attention to the emotions, feelings, and nonverbal cues they communicate.
Listen carefully and give encouragement.
If you understand only part of the message, explain what you think you understood. Then check whether you understood correctly.
When the Person Struggles to Find Words
A person with dementia may have trouble finding a word or finishing a sentence.
Ask the person to explain the idea another way. Listen for clues in what the person says.
Also watch the person’s facial expressions, posture, and movements. These cues may help you understand how the person feels.
When the Person Feels Sad
Allow the person to express sadness.
Do not try to push the person into feeling cheerful. Sometimes listening and showing that you care is the most helpful response.
Memory Loss Can Affect What the Person Says
Some people living with dementia do not remember information about their medical history, family, or friends.
Use your judgment and respond appropriately to what the person says. For example, a person may say they already ate when you know they did not.
Pay Attention to Body Language
Body language uses gestures, posture, facial expressions, and movements to communicate messages about how a person feels or is doing.
A person with dementia may closely watch your body language.
Sudden movements or a tense facial expression may cause distress and make communication harder.
Make sure your facial expression and body language match your spoken message.
Respect Personal Space and Position
Do not stand too close to the person or stand over them while communicating. This may feel intimidating.
Respect the person’s personal space. Position yourself below the person’s eye level when communicating. This can help the person feel more in control of the situation.
Physical Contact Can Communicate Reassurance
Physical contact may communicate care, affection, and reassurance when it feels appropriate.
Examples include holding or gently patting the person’s hand or placing an arm around the person.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Keep repeating the same message when the person does not understand. | Change the wording or break the explanation into smaller parts. |
| Ask several questions at once. | Ask one question at a time. |
| Ask the person to make complicated decisions or choose from many options. | Give choices the person can manage, and avoid overwhelming them with too many options. |
| Directly correct every statement that is untrue. | Guide the conversation around the subject and look for the meaning or feeling behind the words. |
| Focus only on the person’s spoken words. | Listen to the words and watch nonverbal cues. |
| Stand over the person while speaking. | Respect personal space and position yourself below eye level. |
Fast Review
Focus on the communication patterns that support respect, understanding, and participation.
- People living with dementia may rely more on nonverbal cues as language skills decrease.
- Reduce competing noise and get the person’s attention before speaking.
- Speak clearly, calmly, and slightly more slowly.
- Use short, simple sentences and allow time for a response.
- Ask one question at a time and use yes-or-no questions when needed.
- Avoid complicated decisions and too many choices.
- Rephrase a message or break it into smaller parts when the person does not understand.
- Listen carefully to words, feelings, facial expressions, posture, and movements.
- Avoid directly contradicting a confused statement. Look for the meaning or feeling behind it.
- Keep your body language consistent with what you are saying.
- Respect personal space and avoid standing over the person.
- Include the person in conversations and treat them with patience and respect.
Final Pep Talk
There are many small communication tips in this topic, so give yourself time to sort them into patterns. Focus first on calm speech, simple messages, careful listening, and respectful body language, then review the smaller details.