Dementia and language

A person with any type of dementia can have problems with language. This is because dementia can damage the parts of the brain that control language.

How and when language problems develop will depend on:

• their personality and the ways they manage these language problems
• the type of dementia they have
• the stage the dementia is at. 

When do people with dementia find it difficult to communicate?

Language problems can also vary from day to day, or be more or less of a problem at different times of the day. They can be made worse if the person is tired, in pain or unwell. The surroundings can also help with communication, or make it more difficult.

In some types of dementia – such as some forms of frontotemporal dementia (FTD) – a person may start to have problems with language much earlier than other types of dementia. It is likely to be one of the first symptoms that is noticed.

How can dementia affect how a person communicates?

Dementia can affect how a person communicates and the language they use. They may:

• not be able to find the right words
• use a related word (for example, ‘book’ instead of ‘newspaper’)
• use substitutes for words (for example, ‘thing that you sit on’ instead of ‘chair’)
• not find any word at all
• not struggle to find words, but use words that have no meaning, or that are jumbled up in the wrong order
• go back to the first language they learned as a child. For example, if they learned English as a second language, they may forget how to speak it. 

Following a conversation

Dementia affects the way a person thinks, which can impact on their ability to respond appropriately or follow a conversation. This could be because they:

• do not understand what you have said
• are not able to keep focused
• are thinking more slowly
• are unable to put the correct words together as a reply.

For example, they may take longer to process thoughts and work out how to respond to what is being said. They may also move from one topic to another without finishing a sentence as it becomes harder for them to focus.

For more information on how changes in the brain caused by dementia can affect language, see Dementia and the brain.

What happens when a person's dementia gets worse?

There may eventually come a time when the person can no longer communicate as they once did. This can be distressing and frustrating for them and those supporting them, but there are ways to keep communicating. For example, the person may be able to express themselves through body language and other non-verbal ways.

'This is me'

If a person with dementia is living in a care setting or staying in hospital, any communication problems they have can affect the care and support they receive.

Alzheimer’s Society produces a simple form called ‘This is me’ to help record personal information about a person. This includes how they like to communicate, any difficulties they have, and how care and support staff can tailor their care for them as an individual.

'This is me' is also available in Welsh (Dyma Fi).

What else can affect how well a person with dementia can communicate?

Communication for a person with dementia can be affected by pain, discomfort, illness or the side effects of medication.

If you notice a sudden change in the person (over hours or days), it could be delirium, which is a medical emergency. You should make an urgent appointment with the GP or call the NHS 111 telephone service. Say that the person has changed suddenly, or no longer seems to be acting like their usual self.

There are other reasons communicating with a person with dementia can be difficult. For example, the person may:

• make comments that you or others feel are inappropriate for the situation
• repeat themselves or ask the same question over and over
• believe things which aren’t true.  

For more information on these problems and how to manage them see Changes in behaviour and Caring for a person with dementia: A practical guide.