Information leaflet – Communication advice – caring for people with dementia

General advice

• Listen carefully to what the person has to say.
• Ensure you have their full attention before you speak.
• Speak clearly.
• Consider whether any other factors are affecting their communication.
• Show respect.

Listening skills

• Listen carefully to what the person is saying and give them plenty of encouragement.
• If they have difficulty finding the right word or finishing a sentence, ask them to explain
  in a different way. Listen out for clues.
• If you find their speech hard to understand, use what you know about them to interpret
  what they might be trying to say. Always check back with them to see if you are right −
  it’s infuriating to have your sentence finished incorrectly by someone else!
• If the person is feeling sad, let them express their feelings without trying to ‘jolly them
  along’. Sometimes the best thing to do is to just listen and show that you care

Attracting their attention

• Try to catch and hold the attention of the person before you start to communicate.
• Make sure they can see you clearly.
• Make eye contact. This will help them focus on you.
• Try to minimise background noise, eg radio, TV, or other people’s conversations.

Using body language

• A person with dementia will read your body language. Agitated movements or a tense
  facial expression may upset them and can make communication more difficult.
• Be calm and still while you communicate. This shows the person that you are giving
  them your full attention and that you have time for them.
• Never stand over someone to communicate, it can feel intimidating. Instead, drop below
  their eye level. This will help them feel more in control of the situation.
• Standing too close to the person can also feel intimidating, so always respect their
  personal space.
• If words fail the person, pick up cues from their body language. The expression on their
  face, and the way they hold themselves and move about can give you clear signals about
  how they are feeling.

Speaking clearly

• You may have to initiate conversation with the individual as initiating conversation for
  them can be difficult.
• Speak clearly and calmly.
• Use simple, short sentences.
• Allow them enough time to respond. If you try to hurry them, they may feel pressured
• Avoid asking direct questions. People with dementia can become frustrated if they can’t
  find the answer. If you have to, ask questions one at a time, and phrase them in a way
  that allows for a ‘yes’ or ‘no’ answer.
• If they don’t understand what you are saying, try getting the message across in a
  different way rather than repeating the same thing.

Whose reality?

As dementia progresses, fact and fantasy can become confused. If the person says something you know isn’t true, try to find ways around the situation rather than responding with a flat contradiction, for example, if the person says ‘We must leave now − mother is waiting for me’, you might reply, ‘Your mother used to wait for you, didn’t she?’.

Physical contact

• Even when conversation becomes more difficult, being warm or affectionate can help carers/family to remain close to their loved ones, or for the person with dementia to feel supported.
• Don’t underestimate the reassurance you can give by holding or patting the person’s
  hand or putting your arm around them, if it feels right.

Show respect

• Make sure no one speaks down to the person with dementia or treats them like a child,
  even if they don’t seem to understand what people are saying to them.
• Try to include the person in conversations with others. You may find this easier if you
  adapt the way you say things slightly. Being included in social groups can help a person
  with dementia to preserve their fragile sense of their own identity. It also helps to
  protect them from overwhelming feelings of exclusion and isolation.
• If you are getting little response from the person, it can be very tempting to speak about
  them as if they weren’t there. But disregarding them in this way can make them feel
  very cut off, frustrated and sad

Other causes of communication difficulty

It is important to bear in mind that communication can be affected by other factors in addition to dementia, eg: pain, discomfort, illness or the side-effects of medication. Make sure the person’s glasses are the correct prescription, that their hearing aids are working properly, and that their dentures fit well and are comfortable.

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