Adapting Your Communication Style as a Loved One’s Dementia Progresses

You may already expect that your loved one could eventually have trouble communicating with you as their dementia or Alzheimer’s disease progresses. You may even be exploring how you can help them navigate through the barriers to communication with dementia.

Have you considered how your approach may change as your loved one moves through the stages of dementia? Shifting your own verbal and nonverbal communication style may play an important role in helping your loved one convey their thoughts and needs.

Dementia’s Impact on Communication

A prominent symptom of Alzheimer’s disease and other forms of dementia is “aphasia,” which essentially means the loss of ability to speak and understand speech. In fact, it’s often one of the first signs of dementia, usually in the form of forgotten words or phrases. Over time, memory problems with words here and there may become more frequent, and it may be more difficult to resume a conversation after an interruption. You might also notice frequent topic changes and unexpected substitutions for forgotten words.

Understanding the stages of dementia and communication strategies for how to converse with dementia patients can help you maintain a loving and supportive relationship with your loved one over time.

Communication Barriers and Strategies by Stage

Early:

In the early stages of dementia, you can expect your loved one to have trouble concentrating on a conversation or losing their train of thought. They may forget words when talking or writing, and you may notice some repetition, such as telling the same story again and again or asking a question repeatedly. Often, people with dementia are aware of their mistakes in this stage and will attempt to hide or excuse them.

Be inclusive. As people with dementia become aware of their limitations, they often avoid communicating so they don’t make mistakes. Keeping them engaged can help keep communication skills sharper for longer. Speak directly to your loved one and patiently wait for them to respond without interrupting. Short-term memories can be especially problematic, so use dementia conversation starters such as asking about their childhood or family memories.

Remove obstacles. Make it a habit early on to be conscious of ways you can make communicating with your loved one easier. Eliminate distractions like a TV or radio, and speak in a first language, if possible or relevant. If you’re struggling with how to talk to someone with dementia on the phone, avoid calling later in the day when symptoms tend to be stronger, and be sure your connection is strong for the best sound quality.

Moderate:

You’re likely to notice your loved one struggling more to keep up with a conversation or follow along with a storyline on a TV program, movie or book. Their vocabulary begins to narrow, especially proper nouns and slang terms, and you may notice made-up words replacing forgotten ones or descriptions of objects rather than their actual names. Following directions may become more difficult, and you may see your loved one using hand gestures to express meanings more often.

Slow down. In this stage, speaking slowly and clearly becomes increasingly helpful, as does maintaining eye contact. Clearly enunciate your words, and keep sentences, requests, and stories brief. Similarly, avoid complicated inquiries in favor of questions with simple yes/no answers.

Offer support. Your patience and encouragement may help your loved one feel more confident expressing themselves. Resist the temptation to correct or argue, and instead, listen closely for clues about intended meaning. Use movement and gestures to demonstrate or express your thoughts when words don’t work.

Severe:

Your loved one is likely to be limited to basic conversation and instructions. Vocabulary continues to diminish, including loved ones’ names and other personal details. Following along with storylines is not typically possible in this stage, and you may observe rambling or nonsensical talk.

Use nonverbal cues. Pointing, gesturing, and other body language can be increasingly effective as verbal language becomes more restricted. You can also engage the senses to help communicate through touch, taste, smell, sight, and sound.

Focus on emotion. Even when you can’t grasp the specific words a loved one is trying to express, you can pick up on the emotion or meaning. Help your loved one maintain their dignity and reduce frustration by communicating respectfully. Know that sometimes simply being present (whether live or in a video or phone call) speaks volumes. A loving embrace or a warm smile is a universal language without words.

End-Stage:

Speaking and responding is highly limited and may be limited to nonverbal expression only. When it comes to comprehension, your loved one is likely unable to understand you most, if not all, of the time.

Offer reassurance. Patting or holding a hand while you visit can be comforting. Watch for body language to ensure your loved one is receptive to this form of communication. Maintain an upbeat and friendly tone, and avoid expressing frustration.

Find Additional Support for Your Loved One

At Springpoint Living at Manalapan, our expert care team is specially trained in caring for residents with various stages of memory loss. Schedule a visit to learn more about our memory care services and the safe, supportive, and secure environment we provide for seniors living with Alzheimer’s disease and other forms of dementia.