How does dementia affect communication? 

As human beings, we communicate with each other using an array of verbal and non-verbal communication. From our facial expressions and body language to the words we speak and tone we use, these are the tools we often take for granted to help us express ourselves and feel understood.

All forms of dementia can affect communication in all kinds of different ways. Although this can be challenging and sometimes frustrating or distressing – there are ways that you can help to support and maintain communication.

Why is communication important?

Communication is a vital part of our lives. It allows us to express who we are and relate to one another. Communication is more than talking and listening – it involves understanding and interpreting.

When a person living with dementia is having trouble expressing themselves or understanding what is being communicated, try these tips to help you stay connected.

Communicating well with a person with dementia

How does dementia affect communication?

Dementia can make it more difficult to communicate with others. As dementia progresses it becomes harder for a person to tell others about themselves and to understand what others are saying to them. This leads to people feeling cut off and isolated.

Behavior as communication

At this stage, behaviors are often the only way to communicate what is on the person’s mind. These are called dementia-related behaviors. They are messages about ideas, feelings, and needs, and he is telling you in the best way he can the only way he can.

For instance, a caregiver who provides personal care (bathing, toileting) too quickly causes frustration for the person living with dementia; he can’t process what is happening. Frustration can turn to resistance, anger, and even aggression, all of which may be avoided if the caregiver understands the needs of the person in his or her care, which in the case of this example is simply to move slower and with greater care.

How to approach communication with people living with dementia

Believe that communication is possible at all stages of dementia:

What a person says or does and how a person behaves has meaning.

Never lose sight of the person and what they are trying to tell you.

The key to positive conversations with people living with dementia isrespectful, sensitive and consistent communication.

Difficulties with communication can be discouraging for the person living with dementia and families, so consider creative ways to understand and connect with each other. In the video below, listen to what other caregivers have to say about caring for and communicating with people living with dementia.

The strategies discussed in the video above, as well as the tips listed below, are successful because they are based on a person-centred philosophy that views people living with dementia first and foremost as individuals, with unique attributes, personal values and history.

We also recommend learning as much as you can about dementia, its progression and how it can change the abilities of a person. As abilities change, you can learn to interpret the person’s messages by paying attention to both verbal and non-verbal cues.

The right environment

When communicating with a person with dementia, try to:

avoid competing noises, such as TV or radio

stay still while you are talking – this makes it easier for the person with dementia to follow what you are saying

maintain regular routines – this helps to minimise confusion and can assist communication

keep a consistent approach – it is much less confusing for the person with dementia if everyone uses the same style of communication. Repeating the message in exactly the same way is important for all the family and carers.

Listening to and understanding someone with dementia

Communication is a two-way process. As a carer of someone with dementia, you will probably have to learn to listen more carefully.

You may need to be more aware of non-verbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking.

Active listening can help:

use eye contact to look at the person, and encourage them to look at you when either of you are talking

try not to interrupt them, even if you think you know what they’re saying

stop what you’re doing so you can give the person your full attention while they speak

minimise distractions that may get in the way of communication, such as the television or the radio playing too loudly, but always check if it’s OK to do so

repeat what you heard back to the person and ask if it’s accurate, or ask them to repeat what they said

Will communication get harder?

As time goes on, communication will likely become more difficult for someone with dementia. Although dementia can take years to advance over several stages, symptoms can worsen in each subsequent stage.

The silver lining

As with much of life, there is a silver lining to the reality of dementia-related language decline. The brain’s temporal lobe is two-sided. The left side deteriorates while the right side remains intact, often to the end of the dementia journey. The right side enables a person to engage in basic social chit-chat, clap or toe-tap to the rhythm of music and poetry, and even dance.

A person living with dementia can find great comfort and joy in listening to his favorite music or singing along to songs from his past. It’s not uncommon for a person to retain the ability to recite favorite scriptures or poems, even word for word. This can happen even in persons who are otherwise non-verbal.

Care partners can learn new ways to interact with their loved ones who have dementia by engaging in activities that rely on the right side of the temporal lobe.