If you have a loved one with dementia, you may find that you have to change the way you communicate with them, particularly in the later stages of the condition. We know that it can be challenging for both you as a friend or family member, and for the person suffering from dementia, so we have created this guide to make it easier for both you and your loved one to interact.
How can Dementia affect communication and interaction?
Communication can be difficult for people living with dementia at both the early and later stages of the condition. That’s because dementia affects the part of the brain that controls language, and it’s something that is common to every type of dementia – although the severity with which speech and language are affected will depend on the type of dementia, the stage of dementia and the person. Some ways in which communication might be affected include:
Being unable to find the right word
Using substitutes if unable to find the right word
Using words in the wrong order
Reverting to their first language
Difficulty forming complex sentences
Inability to read facial expressions or social cues
Finding it hard to follow a conversation
Describing objects rather than calling them by their name
Speaking less often than usual
Using gestures instead of words
How to interact with a Loved One with Dementia
Whatever stage of their dementia the person is at and whatever type of dementia your loved one has, there are ways to make the experience better for both you and the person you care about.
What to consider before the conversation
Before you start a conversation, think about the setting. It is best to communicate in a quiet, calm place, with good lighting and a quiet background. Background noise can make it more difficult for a person with dementia to follow a conversation, so turn off the radio or TV, and minimise distractions if you can.
It’s also a good idea to plan enough time to talk with your loved one. Whether it’s an important conversation or just a catch up, you don’t want it to be rushed as this is likely to make both of you feel stressed and frustrated. You may also want to consider what you’re going to talk about in advance.
You should also ensure that they’re not hungry, in pain, or engaged in another activity before you start your conversation. Make sure you have their full attention and you’re not trying to get them to focus on two things at once.
Being a good listener
Listening skills are really important for you as a friend or family member of someone with dementia – after all, listening is the key to any good conversation. Here are some tips for making the most of your conversation through listening skills:
Don’t interrupt the person speaking. Let them talk, even if they are having difficulty finding a word, as interrupting them can disrupt their thinking process and cause a communication breakdown
Allow them lots of time to respond to you. Have patience, as they may take longer to process what you have said and come up with a response
If they are struggling to find the right word, listen out for clues to help you understand.
If you have not understood what they have said, ask them if they can repeat it
Offer lots of encouragement through eye contact, nodding and subtle verbal cues to acknowledge that you have understood what they are saying
If they are upset, or they become distressed during the course of your conversation, let them express their feelings and show that you are there for them simply by listening.
Tips for communicating
As well as listening well, there are a few things you can do to ensure that what you are saying is understood:
Stand or sit in such a way that your loved one can hear you clearly as well as see your facial expressions and body language, all of which are important conversational tools
If they are having difficulty following what you are saying, speak clearly and calmly, and slightly slower than you usually would
Try not to use overly complex sentences, but don’t talk simplistically or treat them like a child
Give them time to respond to each thing you say – and don’t worry if the pauses between sentences or questions feel too long. It’s important to give your friend or family member a chance to process what you have said and respond
If there are other people in the room, don’t exclude the person with dementia – it’s important not to talk as though they are not there
Even if you feel frustrated, try not to snap or raise your voice.
Interactions at each stage of Dementia
As well as these general tips for interacting with your friend or relative, we’ve compiled some useful things to bear in mind for each stage of dementia, where their needs may differ.
At the early stages, people can participate in their usual social activities and have meaningful conversations – but they may repeat stories, have trouble finding the right word, or perhaps feel overwhelmed during long periods of conversation or social interaction. Here are some things to consider:
Ask your friend or family member what they are comfortable with, and what the best way to communicate with them is. Do they prefer face-to-face conversations, or would they feel more comfortable with a phone call? Maybe they like emails better so they have more time to compose their thoughts and respond
Don’t make any assumptions just because they have dementia. Everyone is different, so if you’re unsure about their ability to communicate, it’s best to have an open and honest conversation about it
Inject a little laughter into the situation with good-natured humour. It can make it easier for your loved one and it shows that you care.
Communication may become more difficult in this stage – although the middle stages of dementia can last for years, your loved one’s communication may ebb and flow during this time. Some tips for a successful conversation include:
Asking one question at a time
Using closed questions rather than open ones
Giving visual cues
Communication is likely to be the most difficult at this stage, but it is still important to interact with your loved one and show how much you care about them. Here are some things to try:
Use non-verbal communication if they find speaking difficult. You could ask them to point or gesture to help them express themself
Can you introduce any sounds, smells or textures into your conversation? These are good ways of interacting without the need for verbal communication
Introduce yourself to your loved one before you start speaking, and try to approach them from the front if possible
If the conversation is difficult or you don’t know what to say, that’s okay. Remember that the most important thing is to show them that you are there and that you care.