For people living with dementia, communication may become increasingly difficult. This can be because of neurological disease, but may be increased by the failure of others in contact with the person living with dementia to compensate for their impairments or to facilitate use of their retained abilities. 

Poor communication may result in high levels of anxiety and depression for the person living with dementia. Communication breakdown contributes to high rates of depression in spouses of people living with dementia and is a major problem for family and carers. Positive and supportive communication is essential to ensure good quality dementia care.

A person-centered approach focuses on supporting a person to use and retain their skills and abilities. Person-centered communication involves a commitment to including the perspective of the person living with dementia, and an understanding of who the person is, their life history and preferences.

Problems you can expect to see throughout the progression of the disease include

•  Difficulty finding the right words

•  Using familiar words repeatedly

•  Describing familiar objects rather than calling them by name

•  Easily losing a train of thought

•  Difficulty organizing words logically

•  Reverting to speaking a native language

•  Speaking less often

•  Relying on gestures more than speaking

Tips for successful communication

•  Engage the person in one-on-one conversation in a quiet space that has minimal distractions.

•  Speak slowly and clearly.

•  Maintain eye contact. It shows you care about what he or she is saying.

•  Give the person plenty of time to respond so he or she can think about what to say.

•  Be patient and offer reassurance. It may encourage the person to explain his or her thoughts.

•  Ask yes or no questions. For example, “Would you like some coffee?” rather than “What would you like to drink?”

•  Avoid criticizing or correcting. Instead, listen and try to find the meaning in what the person says. Repeat what was said to clarify.

•  Give visual cues. Demonstrate a task to encourage participation.

•  Avoid arguing. If the person says something you don’t agree with, let it be.

•  Offer clear, step-by-step instructions for tasks. Lengthy requests may be overwhelming.

•  Written notes can be helpful when spoken words seem confusing. 

•  Approach the person from the front and identify yourself.

•  Encourage nonverbal communication. If you don’t understand what the person is trying to say, ask him or her to point or gesture.

•  Use touch, sights, sounds, smells and tastes as a form of communication with the person.

•  Treat the person with dignity and respect. Avoid talking down to the person or as if he or she isn’t there.

•  It’s OK if you don’t know what to say; your presence and friendship are most important.

•  Ask one question at a time.

•  Consider the feelings behind words or sounds. Sometimes the emotions being expressed are more important than what’s being said.