It is not always easy to understand what people with dementia are saying because they may just mumble, not speak at all, or may say things that do not make any sense to you. Sometimes they might just scream or cry. Not being understood or being able to understand someone can be very frustrating for both of you. Remember that each person with dementia is different so you will have to try and find out the best way to communicate with the person. Communication is not just talking (what you say); it is also how you say it, how you stand, what your face looks like and how you touch the person. The worse people get, the more you will have to show what you want to say. It may become so bad that they do not even remember your name or recognise who you are or who the closest member of the family is. It is therefore important that you learn as much as you can about the person from the family and/or friends. At all times, it is important to give the same attention and respect to people with dementia that you would to anyone else.

How to communicate

  • The first thing is to make sure that the person can see you. Stand in front of her/him if s/he is standing, or sit in front of her/him if s/he is sitting. If there’s a hearing aid, check that it’s on and that the person’s dentures are in and fit properly.
  • Touch her/him and say her/his name so that the person knows you are talking to her/him. Using people’s names may also keep their attention and help them to remember who they are.
  • Make sure that you are close enough for them to see your lips move and see any movements you make with your hands.
  • It is important that there are no other noises that will distract them. If you cannot turn the noise down, then take the person to another, quieter room.
  • Holding the person’s hand or sitting with your arm around her/him will show that you care. Some people do not like to be touched, and may pull away. This is their choice and it must be respected.

Speaking to the person

  • Speak slowly and quietly in a calm voice. Never shout or raise your voice because if you do, the person will become anxious and not hear what you are saying. It is also important to be relaxed so that you smile and do not look angry.
  • People’s expressions, the way they stand or move, may also give you clues to what they are trying to say.
  • Keep the sentences short so that the person can remember what you are saying.
  • If you ask a question, make sure that you keep it short and ask only one question at a time, getting the answer to the first question before you ask the next one.
  • You might have to repeat what you said a few times. If this is so, it might be necessary to speak more slowly and clearly or change the words you are using.
  • Even if the person does not seem to understand, do not use baby talk or speak to the person as if s/he’s a child.

Listening to the person

  • Listen carefully. If you do not understand, do not pretend that you do. Guess what they are saying but ask them if you are right. You can ask them to repeat what was said but do not ask them to repeat it more than three times. Rather, ask them to show you what they mean, if they can.
  • If their speech has become bad and you know them well, you might be able to guess what they are trying to say or are feeling by using what you know about them. Once again, ask them if you are right. Another way is to encourage them to use body movements to help you understand.
  • As the disease gets worse, people may become confused and talk about things that are not true. It is not always necessary to correct them but if you do need to, try to correct them in a nice way so that they do not feel foolish. An example would be someone saying that her mother is coming to visit and you know that her mother is dead. Rather than correcting her, think about why she would say that. Maybe she is missing her mother? Talk to her about her mother and ask what she was like. Maybe she just needs a hug.
  • If people become confused in a short time, it could be that they are in pain, feeling uncomfortable, may be sick or the effects of the medicine may also make them confused. This needs to be reported to the clinic or doctor.
  • If they seem sad, show them that you understand and encourage them to tell you why they feel sad.

Other tips

  • Laugh together about misunderstandings or mistakes and reassure them that it really isn’t a problem. Encourage them to talk because sometimes they might feel shy and stop talking.
  • Another method of communicating is by using a board or piece of paper with pictures stuck on it. For example, cut out the pictures from advertising pamphlets or magazines of a toilet, shower, bath, clothes, different vegetables, meat, a knife and fork and other pictures that you feel would make communication easier. People can then point to what they want.
  • A scrapbook with photographs and pictures showing the life of the person can also be a nice way of communicating as you can page through the book together and talk about the pictures.