Communication Factsheet

Problems that dementia causes with communication

The person you are caring for may be trying to interpret a world that no longer makes sense to them because their brain is interpreting information incorrectly.
Sometimes you and the person you care for will misinterpret each other's attempts at communication. These misunderstandings can be distressing for both parties.
A person with dementia may repeat what they are saying, may be slow to find a word or have difficulty finding the correct word, particularly the names of objects, places, people.
They may find it difficult to ‘initiate’ or start to do something, follow a conversation, follow a television programme, read a book or magazine.
They may start to say something and then forget what he/she was talking about. The person may say things that are not true.
Many of these problems worsen as the person’s dementia develops.

Try to be ‘person centred’ in your dealings with them – appreciate the person’s difficulties, help them by focusing on what they can still do.
Acknowledge and clarify the person’s feelings and what they are trying to communicate. This helps to ‘validate’ their experience.
Try not to contradict or argue, just ‘go with the flow’. It may sound like a tall order to do this but an argument will exhaust you both and there will be very few winners. Winning an argument relies on remembering what has been said or agreed – and the person you care for may not be able to recall what has happened.

Make sure you have the person’s attention before speaking to them. A person who has dementia may take some time to ‘tune in’ to what is happening. Have they just woken up, do they need time to adjust?
Speak clearly and calmly. Try to avoid speaking sharply or raising your voice as this can cause distress to a person who has dementia.
Processing information will take the person longer than it used to – so allow time for a message to ‘get through’.
Use simple, short sentences. A person who has memory loss is likely to remember the last thing that has been said.

Make sure that the lighting is sufficient for the person to see you and, if wearing glasses, that they are clean.
Make sure that unnecessary noise is reduced. A person who has dementia will have difficulty concentrating on too many things at once. Sounds like the TV, washing machine, vacuum cleaner etc can be very distracting.
Avoid too many closed questions (questions which require a ‘Yes’ or ‘No’ answer) - you might always get “No”! Instead of asking ‘Would you like a cup of tea?’ which might be declined - even though you know the person is thirsty – try something like ‘I’m just going to make a cuppa – do you fancy a biscuit with yours?’.
If the person you care for doesn’t understand what you are saying, try getting the message across in a different way.
As the dementia progresses, the person may become less able to start a conversation, so you may have to start taking the initiative.
In conversation, use familiar names and family phrases and jokes that the person has known for a long time. This can give a person a frame of reference for communication when everything else seems hard to grasp.

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