19 Apr, 2022

One of the many challenges of caring for seniors living with dementia is communication, and it ranks high among family caregivers’ concerns. For family caregivers without specialized dementia training, handling communication problems can be frustrating when speech ability continues to regress.

Still, like other concerns with providing care, anyone can learn how to nurture positive and engaging conversations with experience. The key is to take a different approach to communication, and it includes speaking with respect and being more sensitive to different communication cues.

Declining Communication Ability

At the early stage of dementia, your senior parent can still engage in meaningful social talks. However, a subtle decline in the communication ability manifests as repeated words or difficulty recalling the right words. These communication concerns get progressively worse as dementia affects other areas of the brain.

When dementia turns severe, you need to be more sensitive to catch nonverbal cues, like vocal sounds or facial expressions, to understand what your loved one is saying. You also need to learn other forms of communication aside from spoken words to relay your response.

Overcoming the challenges in communication

Aphasia is a language disorder that causes a decline in comprehension and expression of speech when a person suffers from specific types of brain diseases, including Alzheimer’s – the most common form of dementia. It can damage the brain area that controls language mechanisms, leaving the person with declining communication skills.

Hence, when talking to a senior relative living with dementia, one crucial thing to reconsider is the brain functions. It is vital that you match their level of communication ability to ensure an effective exchange of ideas.

Here are some communication challenges and ways to work through them:

    1. Trouble finding or recalling the right words:

    Be patient and give your loved one enough time to think. Suggest some words relative to the topic you are talking about to recall the right words.

    2. Repeating words, topics, or questions:

    Distract your loved one from repetitive thoughts and propose a topic that can tug at their interest, such as about their grandchildren, or if their birthday is coming up, ask how they want to celebrate it.

    3. Mixing irrelevant ideas:

    Instead of making sense of what they say, focus on their emotions and body language. You may understand their body language and emotions better than spoken words. Reframe the conversation if needed and find ways to work with it.

Tips to help you communicate with a senior living with dementia

Effective dementia care requires rigorous and ongoing training. But in many cases, the caring role comes suddenly for family members-turned-caregivers, leaving no time for training. In a study by JAMA Internal Medicine, 93% of family caregivers are untrained, resulting in poor execution of their caregiving tasks and a negative impact on these family caregivers’ well-being.

As seen today, many caregivers rely on online caregiving resources to teach themselves to provide adequate care, including communication strategies with a loved one diagnosed with dementia.

Here are some tips to create a meaningful interaction with someone with cognitive decline:

  • Before you talk to them, make sure your loved one is feeling well – for example, they are not hungry or enduring some pain.
  • Speak to them directly, not to their caregiver.
  • Use familiar words and short sentences. Speak slowly and clearly.
  • Use a friendly tone. Do not “baby talk” or use childish language, like using “diaper” instead of “underwear.”
  • Maintain eye contact while talking to show a connection.
  • If they are sitting, talk to them while also sitting. It helps them calm down when you speak on the same face level.
  • Offer choices on requests – for example, if your parent is reluctant to shower, you may say, "Would you like to shower before or after dinner?"

What to do when your loved one with dementia is talking:

  • Be patient and understanding.
  • Do not interrupt. Give your loved one ample time to organize their thoughts and think of a response.
  • Use body language to provide assurance, such as holding their hands or tapping their shoulder.
  • Learn to interpret body language and other communication cues, especially when verbal communication does not work anymore.
  • Never argue, criticize or correct them.

What is the ideal environment when communicating?

A good environment is essential for a meaningful communication experience. If your senior loved one isn’t comfortable in their environment, they may lose focus and will not understand your conversations. Here are some tips to provide a suitable environment for communication:

  • Choose a quiet and calm place – a busy environment causes confusion and makes it hard to pay attention to the conversation.
  • Choose a place with good lighting.
  • Get rid of distractions, such as TV, radio, or smartphone.
  • Figure out which is the best time to talk – for instance, if they can communicate more clearly in the morning and their mood is the best, schedule your talk at this time.

The Role of Active Listening in Encouraging Communication

Meaningful conversations are difficult to establish during the mid to late stages of dementia. As the brain damage expands further, communication skills regress. At the last stage, severe brain impairment causes speech ability to reduce to about a half-dozen comprehensible words.

At all stages of dementia, active listening is the key to encouraging communication with someone with diminished cognitive ability. As a family caregiver, remember that it’s better to listen than talk. When you keep your ears open, you get a good grasp of what your loved one wants to say or how they feel about something, improving communication. You can have a rewarding interaction by maintaining eye contact and not interrupting them when they speak.


Patience and understanding are essential qualities when communicating with someone living with dementia, especially at the later stage of the disease when verbal communication is impossible. Learning nonverbal communication using facial expressions, gestures, and body language can become the primary communication avenue when they lose their speech ability.

With or without the challenges of dementia, active listening has been a critical factor in effective communication. By listening actively to what your loved one is trying to convey, you can make the conversation engaging and a pleasant experience for them.

Syed Rizvi

Syed has years of experience dealing with people, understanding their needs, and helping them find solutions to their problems.
As a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP), Certified Montessori Dementia Care Professional (CMDCP), Syed is committed to working closely with Senior and their family knowing what is it like for individuals facing a challenging time, at times groping in dark trying to figure what is the appropriate next step or care level for their unique situation.
Syed and Senex Memory Advisors are fully committed to working closely with families in creating a personalized, step-by-step process memory care plan at zero cost.

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