Living with Alzheimer’s and dementia can make it very hard to say what you need or how you feel. This can be very frustrating and upsetting for the patient and for those around them.

Speaking

Speaking clearly and in short sentences is important. Some people may understand writing more easily than speech, so try jotting things down. If you are offering choices, make these simple and avoid the temptation to choose for the patient. Closed questions with simple Yes/No answers can be best. If a person doesn’t seem to understand, try re-phrasing, and always be patient, however frustrated you may feel. Allow the person plenty of time to process and respond. A patient may take things you say very literally, so try not to use irony and sarcasm - say it like it is!

Visual Prompts

Giving prompts of photos of people and places that you know are familiar to the patient can help provide them with a reason to communicate. Often patients really enjoy communicating about their past, and memory boxes can be extremely useful. If they are with others, always try to include the patient, even if they are not always able to follow what is going on. Sometimes the best way to communicate with someone with dementia is to do something they love, such as playing a game or doing a hobby.

Listening

If a patient is trying to speak for themselves, show them that you are listening and give them your full attention. Smile, and use eye contact. Having the radio or TV blaring is a bad idea. If a person says something unusual, don’t ridicule them. Acknowledge what they have said and show that you are listening. If a patient says something untrue, don’t contradict them. Look for meaning behind what they are saying, and if they repeat something multiple times try to act as though this is the first time you have heard. You must bear in mind when talking to a person with dementia that their perception of reality may be very different from yours…but it will be the only one they know.

Non-Verbal

Facial expressions and gesture are also ways to communicate with dementia patients. Be mindful of your tone of voice and your expression as the patient may detect if you are being negative. A patient may understand much more than you think, so never talk about a person in front of them. Remember that if you are too close, invade their personal space or stand above the patient, you may come across as intimidating. Aim to be at their level or lower and be sure they can see you.

People living with dementia may have hearing issues, such as impacted ear wax, which could affect their ability to communicate. If hearing aids are worn, check that the batteries are working. Poor vision can also make a real difference to what is understood: glasses need to be well-fitting and cleaned regularly. Sensory impairments will already make a person feel isolated, so it is vital that vision and hearing are monitored.