Talking to a person with Alzheimer’s or dementia can be a challenge. Get practical tips on how to do it with compassion.

Published: June 22, 2016 | Updated: November 27, 2019

More than 5 million people in the United States have Alzheimer’s disease or dementia. It affects 11 percent of seniors in Kentucky alone. Chances are you know someone with one of these diseases — a family member, friend or neighbor.

Alzheimer’s and other dementias slowly take away a person’s ability to communicate. These changes in the way the mind works can lead to frustration, social isolation and even a total loss of speech.

Communicating requires patience, understanding, listening skills and, above all, compassion.

How communication changes

Early on in the disease, a person may just repeat stories or not be able to find a word. Later, the person may:

• Use familiar words repeatedly or incorrectly 
• Invent new words to describe familiar things
• Lose their train of thought
• Have difficulty organizing words
• Speak less often
• Have trouble understanding others

“If the person is having false beliefs about reality (delusions), is hearing voices or seeing things that are not there, it is not helpful to challenge their sense of reality. This can cause frustration and mistrust,” said Bradley S. Folley, Ph.D., neuropsychologist with Norton Neuroscience Institute. “It may be more useful to provide some validation along with alternative ideas or solutions.”

For example, if the person has lost an item because he or she put it away for safekeeping and cannot find it later, he or she may conclude that someone is coming into the house and stealing items. Even though this is false, avoid invalidating that conclusion. Simply ask the person to work with you to make sure valuable or important items are kept in a secure location.

Nonverbal communication tips

• Treat the person with dignity and respect.
• If you offer to assist with a task, wait for your offer to be accepted before standing up or leading them by the arm.
• Be aware of your own attitude or mood and what your tone of voice or body language might be telling the person.

Verbal communication tips

• Adjust your voice to their hearing ability.
• Speak from feelings, not judgments or observations. Example: “Can I help?” instead of “You look lost.”
• Avoid evaluations. Example: “I’ll find that for you” instead of “It’s right there on the table.”
• Offer answers instead of asking questions. Example: “The bathroom is right here” instead of “Do you need to use the bathroom?”
• Stay away from negative phrases. Example: “Let’s go here” instead of “Don’t go there.”
• Don’t correct the person or tell them what they are saying is wrong. Instead, repeat what the person is saying or simply acknowledge it and move on.
• Avoid arguing, no matter how much you disagree. Arguing often brings about agitation from the person with dementia.
• If the person cannot find a word, offer a guess or ask the person to point or gesture.
• Pay attention to tone of voice or actions that may demonstrate the person’s feelings. These may be more important than what the person is trying to say.
• When talking to others in the room, don’t speak as if the person with dementia isn’t there or can’t hear or understand you.

Although the disease causes major changes in the way a person functions, always remember your loved one still has the ability to appreciate, respond to and experience feelings such as joy, anger, fear, love or sadness.

Continuing to communicate even if your loved one can’t respond shows them that you still care about and support them.