Trying to communicate with a person who has Alzheimer’s disease can be challenging. Communication skills are gradually eroded by dementia, so their behavior and words can become difficult to understand. They will also have difficulty understanding your actions and your words.

This combination creates misunderstandings and can cause tempers to rise on both sides. Knowing what to expect and learning how to communicate effectively as dementia progresses is important for everyone involved.

Dementia damages the neural pathways in the brain. This makes it difficult to understand what others are saying and find the right words to express what you mean.

A person with Alzheimer’s may incorrectly substitute one word for another, or create an entirely new word to use instead. They may get stuck in a rut and repeat the same word over and over, or ask you the same question repeatedly. They may also:

Lose their train of thought mid-sentence.
Need extra time to process and understand what you’re saying.
Struggle to organize their words in a logical sentence.
Begin to speak in a way that’s out of character for them – like cursing or using offensive language.

What can you do to help?

It is challenging, but you can learn to communicate effectively with a person with Alzheimer’s. Here are some suggestions:

Minimize distractions. Turn off the TV or the radio and try to minimize other outside noise.

Speak clearly. Speak in a clear, concise and straightforward manner. Introduce yourself regularly if needed.

Keep it simple. Use common words and short, direct sentences. Ask questions that can be answered with yes or no, and don’t ask more than one question at a time. Break requests down into single steps.

Don’t interrupt. It may take a while for a person with Alzheimer’s to respond to a question. Be patient and let them finish, and avoid rushing, correcting or criticizing them.

Show interest. Maintain eye contact, and stay focused on he or she, so they will know that you’re listening and trying to understand.

Use visual language. A gesture or a visual cue can help you communicate. If you’re asking them if they need to use the bathroom, take them there and point at the toilet while asking the question.

Don’t argue. The reasoning and judgment of a person with Alzheimer’s gradually declines over time. Keep agitation and anger to a minimum by not engaging in any arguments.

Keep calm. Even when you’re frustrated, stay calm and keep your tone gentle. Your nonverbal cues, like body language and tone of voice, may be sending a message.

Be respectful. Don’t use “baby talk” and don’t use diminutive language, e.g. “good boy” as praise. Do not assume that they can’t understand when you’re struggling to communicate with them. Never talk about them as if they weren’t there.

Communicating with a person with Alzheimer’s may become increasingly challenging as the disease progresses. Remember that your loved one isn’t acting this way on purpose. Don’t take their words and behaviour personally. You can help them feel secure and safe by being patient and understanding.