How to communicate with a person with dementia

These tips apply to however the person usually communicates, for example speaking English or signing British Sign Language.

Every person’s experience of dementia is unique, so not every tip may be helpful to the person you care for. Use the tips that you feel will improve communication between you. 

Before you communicate

Making sure the person is comfortable

• Make sure you’re in a good place to communicate. Ideally it will be quiet and calm, with good lighting. Busy environments can make it especially difficult for a person with dementia to concentrate on the conversation, so turn off distractions such as the radio or TV.
• If there is a time of day where the person is able to communicate more clearly, try to use this time to ask any questions or talk about anything you need to. 
• Make the most of ‘good’ days and find ways to adapt on more difficult ones.
• Make sure any of the person’s other needs are met before you start – for example, ensuring they are not in pain or hungry.

Preparing to communicate with a person with dementia

• Think about how you might feel if you struggled to communicate, and what would help.
• Plan enough time to spend with the person. If you feel rushed or stressed, take some time to become calmer beforehand.
• Think about previous conversations you have had with the person and what helped you to communicate well then.
• If the person has begun to communicate using the first language they learned, and you do not speak it, consider arranging for family members or friends who also speak the language to be there with you. If the person prefers reading, try using translated written materials. A translation or interpretation app on a smart phone or tablet can translate between you if you don’t speak the same language. If you need an interpreter, speak to your local authority, the person’s care home, or an organisation such as the Institute of Translation and Interpreting.
• Get the person’s full attention before you start.

Things to consider about conversation topics

• Think about what you are going to talk about. It may be useful to have an idea for a particular topic ready. 
• If you are not sure what to talk about, you can use the person’s environment to help – anything that they can see, hear or touch might be of interest.

Listening

Tips for listening to a person with dementia

• Listen carefully to what the person is saying. Offer encouragement both verbally and non-verbally, for example by making eye contact and nodding. This ‘active listening’ can help improve communication.
• The person’s body language can show a lot about their emotions. The expression on their face and the way they hold themselves can give you clear signals about how they are feeling when they communicate.
• If you haven’t fully understood what the person has said, ask them to repeat it. If you are still unclear, rephrase their answer to check your understanding of what they meant.
• If the person with dementia has difficulty finding the right word or finishing a sentence, ask them to explain it in a different way. Listen and look out for clues. If they cannot find the word for a particular object, ask them to describe it instead.

Supporting the person to express themselves

• Allow the person plenty of time to respond – it may take them longer to process the information and work out their response.
• Try not to interrupt the person – even to help them find a word – as it can break the pattern of communication.
• If the person is upset, let them express their feelings. Allow them the time that they need, and try not to dismiss their worries – sometimes the best thing to do is just listen, and show that you are there.

How to communicate

Ways to communicate with a person with dementia

• Communicate clearly and calmly.
• Use short, simple sentences.
• Don’t talk to the person as you would to a child – be patient and have respect for them.
• Try to communicate with the person in a conversational way, rather than asking question after question which may feel quite tiring or intimidating.
• Include the person in conversations with others. It is important not to speak as though they are not there. Being included can help them to keep their sense of identity and know they are valued. It can also help them to feel less excluded or isolated.
• If the person becomes tired easily, then short, regular conversations may be better.
• Avoid speaking sharply or raising your voice.   

How to pace conversations

• Go at a slightly slower pace than usual if the person is struggling to follow you.
• Allow time between sentences for the person to process the information and respond. These pauses might feel uncomfortable if they become quite long, but it is important to give the person time to respond.
• Try to let the person complete their own sentences, and try not to be too quick to assume you know what they are trying to say.

Things to consider about body language

• Stand or sit where the person can see and hear you as clearly as possible – usually this will be in front of them, and with your face well-lit. Try to be at eye-level with them, rather than standing over them.
• Be as close to the person as is comfortable for you both, so that you can clearly hear each other, and make eye contact as you would with anyone.
• Prompts can help, for instance pointing at a photo of someone or encouraging the person to hold and interact with an object you are talking about.
• Try to make sure your body language is open and relaxed.

What to communicate

Tips for asking questions

• Try to avoid asking too many questions, or asking complicated questions. The person may become frustrated or withdrawn if they can’t find the answer. 
• Try to stick to one idea at a time. Giving someone a choice is important, but too many options can be confusing and frustrating.
• Phrase questions in a way that allows for a simple answer. For example, rather than asking someone what they would like to drink, ask if they would like tea or coffee. Questions with a ‘yes’ or ‘no’ answer are easier to answer.

What to do if the person has difficulty understanding

• If the person doesn’t understand what you’re saying even after you repeat it, try saying it in a slightly different way instead.
• If the person is finding it hard to understand, consider breaking down what you’re saying into smaller chunks so that it is more manageable.
• Try to laugh together about misunderstandings and mistakes. Humour can help to relieve tension and bring you closer together. Make sure the person doesn’t feel you are laughing at them.