A neuropsychologist offers ways to improve communication with someone who has Alzheimer’s disease or dementia

Published: October 8, 2018 | Updated: March 10, 2023

Nearly 6 million people in the United States have Alzheimer’s disease or dementia, including more than 90,000 in Greater Louisville. Chances are you know someone with one of these diseases.

“Alzheimer’s and other dementias slowly take away a person’s ability to communicate,” said Bradley S. Folley, Ph.D., neuropsychologist with Norton Neuroscience Institute. “These changes in the way the mind works can lead to frustration, social isolation and even a total loss of speech.”

How communication changes

Communicating with someone with one of these conditions can be challenging. Early on in the disease, a person may 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, is hearing voices or seeing things that aren’t there, it’s not helpful to challenge their sense of reality,” Dr. Folley said. “This can cause frustration and mistrust. It may be more useful to provide some validation along with alternative ideas or solutions.”

For example, if the person can’t find something that they put away for safekeeping, they may conclude a thief has entered the house. Rather than invalidate that false conclusion, ask the person to help identify a secure location for valuables.

If you’re supporting a loved one with Alzheimer’s or dementia, Dr. Folley said there are a number of verbal and nonverbal ways to help:

Verbal communication tips

• Adjust your voice to their hearing ability.
• Don’t correct the person or tell them they’re 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.
• 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.”
• 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.

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 doing the task.
• Be aware of your own attitude or mood and what your body language might be telling the person.

“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,” Dr. Folley said. “Continuing to communicate even if your loved one can’t respond shows you still care about and support them.”