15 Ways Family Caregivers Can Better Communicate With a Loved One With Dementia

Set the stage.

Communication is words and body language and tone of voice and attitude, says Podgorski. “It may take more time for the person with dementia to find words and to process someone else’s communication,” she says. “It is best to have important conversations in a setting without distractions like noise or other people.”

Speak slowly, clearly and enunciate your words.

“Avoid slurring words or mumbling when speaking to someone with dementia,” says Madeline Diaz, Oceana Memory Care director at Inspīr Carnegie Hill in New York City. Keep your hands away from your face when having a conversation. This can help your loved one understand what you’re saying and know how to respond.

Focus on body language.

Gerardo “Jerry” Godinez, the senior residential manager at Noah Homes, a California memory care home for adults with memory loss, says that communicating with someone with dementia [also] depends on your body language and tone of voice.

Diaz suggests giving a loved one the time to recall words as they speak, especially in the middle and late stages of dementia. “A good communicator will show they’re listening by nodding, using eye contact, and friendly facial expressions.”

Join the journey.

“If your loved one wants [something that is] unrealistic — for example, he wants to see his mom who has passed away — then validate the feeling behind the request by saying … ‘[Let’s] look at pictures of her or write her a letter,’” says Godinez. “This is called ‘joining the journey.’ Don’t resist or accuse; join the individual’s train of thought instead. ”

Avoid “remember when?” questions.

“Bringing up past memories with ‘Do you remember when…?’ can evoke frustration in people living with dementia,” says Diaz. “Instead, take the pressure off the individual. Lead by saying, ‘I remember when…’ when bringing up memories.”

Don’t discuss your loved one in front of her.

“Even if your loved one has experienced a decline in her communication skills, we should still talk with her, not about her or over her,” says Lakelyn Eichenberger, a gerontologist and caregiving advocate at Home Instead, an in-home care company headquartered in Omaha, Nebraska.

Make eye contact.

If the person is sitting or in a wheelchair, Godinez suggests sitting down and conversing with him or her at eye level.

Use calming words.

If someone with dementia is upset because she can no longer understand what you or anyone says to her, we should provide verbal reassurance, such as ‘We’re going to figure this out together’ and ‘I’ll do a better job communicating with you,’ says Macie Smith, a gerontology social worker for Synergy HomeCare. “Caregivers should never make the patient feel as if he is the problem because he can’t control what’s happening to him,” she says. “But we can control how we respond.”

Practice patience and compassion. 

“Speak to them as adults, not children,” says Wendy Winokur, the vice president of palliative care, at Traditions Health. She adds that a light touch on the hand or shoulder can convey reassurance. “Show empathy by validating their emotions, even if their words don’t make complete sense.”

It’s normal to feel frustrated when a loved one has difficulty remembering words or thoughts you’ve just shared, adds Diaz. However, the most important part of communicating with someone who has dementia is to have patience and compassion.

Remember: safety first.

“Meeting a person with dementia ‘in their world’ is acceptable to have a positive interaction as long as everyone is safe,” says John Showalter, M.D., the chief strategy officer of Linus Health, a digital health company that enables early detection of Alzheimer’s and other dementias. “If the hallucinations lead to aggression … get assistance from family, staff in a facility, or even paramedics. Do not argue about the reality of a hallucination with a loved one if it makes them more agitated.”

Offer choices.

If your loved one begins to resist a routine task, like eating or showering, provide options to give them a sense of control and independence, says Diaz. “For example, ask, ‘Would you like to eat now or after we take a walk?’”

Stay in the present.

Open-ended questions can become difficult for someone with dementia to answer, explains Diaz. “Instead, focus on the present moment as a conversation starter. For example, rather than asking, ‘Did you have breakfast this morning?’ say, ‘Are you hungry now?’”

Notice cues, phrases and people they respond to.

“It’s difficult to communicate with people who have dementia as this disease affects their perception of reality,” says Luyi Kathy Zhang, a hospice and palliative care physician and director of the Palliative Care Serenity Unit at NYC Health + Hospitals/Bellevue. “Noticing what cues, phrases, and people they respond best to will help make a challenging situation a bit smoother. Things like calming activities, keeping consistent routines, using simple language, and avoiding arguments can help.”  

Redirect when needed.

“If there is a lack of cognition, repeating the conversation may not work,” says Micki Buchanan, director of memory care at United Hebrew, located in New Rochelle, New York. “Try to redirect [their attention] to something that would hold their interest, whether it be eating, showing them pictures of loved ones, singing a song, or doing an activity together. Go for a walk, hold their hand, give them a hug to reassure them.” 

Courses That Can Help

The Alzheimer’s Association website offers additional tips and strategies for communicating with people living with dementia. Its Empowered Caregiver education series also offers dedicated courses on communicating effectively. The Association’s 24-7 Helpline (800-272-3900) is staffed by clinicians to help caregivers navigate disease-related challenges.