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 Learn How to Communicate with a Loved One with Dementia

A man sits on a couch next to his elderly mother and they look at a photo frame together

If your loved one has been diagnosed with Alzheimer’s disease or another form of dementia, you may be completely focused on learning about the condition and what to expect. The decline of communication skills can be one of the most difficult aspects of coping with dementia. Communication breakdowns are frustrating for the person with dementia as well as the people in their lives. 

Having a network of support can help you manage the ups and downs of your loved one’s journey as dementia progresses. Shifting your own verbal and nonverbal communication style to match your loved one’s abilities can make a difference, enabling you to navigate through communication barriers.

Dementia’s Impact on Communication Skills

Alzheimer’s disease and other forms of dementia cause changes in the brain that contribute to memory loss, cognitive decline, and communication challenges over time. For some people, problems with communication may be one of the first signs of dementia. “Aphasia” is a medical term that refers to the loss of ability to speak and understand speech, which can happen gradually in the form of forgotten words or phrases. Over time, communication issues may become more frequent, and your loved one may easily get off track during conversations. 

Understanding the stages of dementia and communication strategies for how to converse with someone with dementia can help you maintain a supportive relationship with your loved one through the ups and downs of dementia care.

Identify Communication Barriers by Stage

Early Stage

It’s common for your loved one to have trouble concentrating on a conversation or losing their train of thought in the early stages of dementia. 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. People with dementia may feel embarrassed by their mistakes and try to hide their difficulties with communication in this stage.

Be inclusive. Even if they used to thrive in a social environment, a person with dementia may withdraw from social interactions because they don’t want to forget people’s names or make other mistakes. It’s important to encourage them to talk and interact with others, because staying engaged can help keep their communication skills sharper for longer.

Remove obstacles. Consider ways to prevent pitfalls with small adjustments that can make communication easier. When you spend time together, create a calm and quiet environment where you can have a conversation without interruptions. Make an effort to eliminate distractions like a TV or radio, and focus on one topic at a time during your conversation. Speak in plain language and avoid using figures of speech, which can be confusing for someone with dementia.

Moderate Stage

Problems related to thinking, speech and communication become more obvious at this stage. 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 as they forget more names of objects and commonly used words. Following directions may become more difficult, and you may see your loved one using hand gestures to express meanings more often.

Speak slowly. Slowing down the pace and speaking clearly can help you communicate more effectively at this stage. Clearly enunciate your words; keep sentences, requests and stories brief. Ask questions that require only simple yes/no answers whenever possible.

Be supportive. Although it’s not easy, approaching every interaction with patience and encouragement can help keep the lines of communication open. Resist the temptation to correct or argue when your loved one says something that’s inaccurate. Instead, be an active listener and offer your support.

Severe Stage

Your loved one is likely to be limited to very basic exchanges of conversation at this stage. They may not be able to respond to you, and you may observe more rambling or nonsensical talk.

Use nonverbal cues. As verbal language becomes more limited, using body language such as pointing or gesturing can be increasingly effective. Look for ways to engage the senses to help communicate through touch, taste, smell, sight and sound.

Focus on emotion. You can send a message to your loved one without using any words. A warm smile or loving embrace is universally understood. Know that sometimes simply being present provides a human connection that can have an uplifting effect.

End Stage

Speaking and responding is highly limited and may be limited to nonverbal expression only. In the end stage of dementia, a person may be unresponsive and unable to understand what is happening around them.

Offer reassurance. People with dementia benefit from the reassurance of spending time with people who care about them, even if they don’t seem to recognize or acknowledge visitors.

Find Support for Your Loved One

Finding ways to communicate with your loved one while they go through the different stages of dementia can be an exhausting, yet emotionally rewarding, experience. Monticello West’s expert Memory Care providers can give you and your loved one peace of mind. From our cozy and secure environment to music and art therapy, we’re passionate about our person-based approach to Memory Care. Schedule a visit today to tour our specialized Memory Care apartments.

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