How To Communicate With a Loved One With Dementia

Stephanie Specht's picture
By Stephanie Specht on January 24, 2018

Communicating with a loved one who is suffering from dementia can sometimes be frustrating for both parties involved.
“As dementia-related diseases progress, the ability of that person to communicate clearly and effectively greatly declines,” explained Lisa Hebert-Meritt, C.O.T.A./L., C.D.P., C.A.D.D.C.T., of Carilion Clinic Home Care, program lead for Carilion’s Alzheimer's Disease and Dementia Management Home Care Program. “And if you are caring for a loved one with dementia, you know that it requires good listening skills, understanding and most of all, patience.”
To help both you and your loved one understand each other better, Lisa shared some of her top do’s and don’ts that she and her team use to help Carilion’s dementia patients and their caregivers understand each other better.

  • Use humor or gentle teasing rather than demanding or ordering the person to perform
  • Be calm, gentle and relaxed; you might find this approach is contagious
  • Speak slowly and clearly, using short, simple sentences
  • Ask questions that require only “yes” or “no” answers
  • Keep the pitch of your voice low and speak in a pleasant, easy-going, warm tone
  • Repeat any instructions in the same way each time
  • Use touch; some people find it very reassuring
  • Talk in an area that is free from distractions
  • Use familiar words
  • Focus on familiar skills and tasks
  • Allow plenty of time for a response
  • Give choices whenever possible, but be careful not to overwhelm your loved one with too many choices
  • Put tasks into simple, one-step instructions
  • Offer praise for success in starting, working through and/or completing a task 

“It is also important to begin conversations in a non-threatening manner and work your way up to the task at hand,” explained Lisa. “This helps to establish rapport and increases cooperation.”
In addition, Lisa added that she has found that dementia patients will often reflect the mood of the caregiver.
“Your body, tone of voice and facial expressions should all reflect the same message,” she said. “People with dementia-related disorders are very aware of non-verbal cues and signs.”

  • Do not tell the person what they cannot do; instead, tell the person what you want
  • them to do
  • Do not argue with the person, confront them or correct their facts
  • Do not give orders or make requests in a demanding way
  • Do not talk down to the person as if the person is a child
  • Do not talk about the person to others as if they are not there
  • Do not ask a lot of questions that require a good memory

“It is also important for caregivers and loved ones to remember that since the disease is progressive, what is understood today may not be tomorrow,” noted Lisa. “Every time a question is repeated or a statement is made, it is the very first time for the person with memory loss.”
To deal with this, Lisa suggests the following:

  • Avoid too much explanation and too much preparation for upcoming events
  • Do not give choices when there are no options (e.g., do you want to take a bath?)
  • Use visual cues like hand gestures to help communicate

 And most of all, do not take things personally.

“People with a dementia-related disorder are usually not deliberately being uncooperative when they do not follow directions, nor are they playing games to get attention,” said Lisa.
If verbal communication fails, Lisa suggests trying a few of the tactics below: 

  • Try distracting the person or diverting their attention
  • Try later or have someone else approach the person
  • Create a new atmosphere with music, a massage, touch or their favorite food

If you cannot respond in a positive way, try to:

  • Ignore the behavior or outburst
  • Apologize
  • Let the subject drop
  • Change the tone with a positive statement

If you are having trouble communicating with your loved one, talk to your health care provider today to learn more tactics that might help you.
Learn more about the seven stages of dementia and common dementia behavior triggers.

If you are caring for a loved one with Alzheimer’s or another dementia-related disorder and find that detecting and soothing your loved one’s agitation is becoming increasingly difficult,  Carilion Clinic is currently conducting a research study that may help.

BESI, which stands for Behavioral and Environmental Sensing and Intervention, is a collaborative effort between clinicians at Carilion Clinic, electrical engineers at University of Virginia and systems engineers at North Carolina A&T.

The study uses wrist-worn sensors to predict what upsets a person with dementia. The hope is that the sensors can detect agitation in the stages before it becomes so severe that no one can effectively intervene.

Volunteers are currently being recruited throughout southwest Virginia. If you are caring for someone at home who has Alzheimer’s disease or other dementias and are interested in participating, please call Temple Newbold, M.S.N., R.N., research nurse coordinator for Carilion Clinic Center for Healthy Aging, at 540-266-6077 to see if you qualify for the research study.