Effective communication strategies for individuals with dementia and their care partners

Tips for the person experiencing communication difficulties

• If you are struggling to find a word, try to describe the word you’re looking for or perhaps draw or mime it.
• Try talking around the subject and the word may ‘reappear’ for you.
• If you feel frustrated, take a breath and walk away if you need to.
• Try to keep doing language-based activities, for example, crosswords, quizzes, and conversations (see our busy minds resource for ideas).
• Think about what you need from communication partners and let them know what would be helpful, for example, to slow down their speech, repeat key information or write it down. A speech and language therapist could help you to work out what helps you.

Tips for people supporting people with communication difficulties

• Ensure the person has their hearing aids if they need them, with charged batteries, and support them to access regular hearing tests.
• Ensure the person has their glasses if they need them and support them to access regular eye tests.
• Make sure the person can see you approaching them, and get their attention before starting a conversation.
• Reduce background noise and distractions, for example, turn off the television or radio and ensure adequate lighting
• Check the person is comfortable and is as free as possible from distractions and not in pain or experiencing illness.
• Ensure you are in the person’s eyeline and sitting or standing at a distance they are comfortable with.
• Encourage the person to keep doing their usual daily activities, with support if this is needed.
• Share non-verbal activities, for example, looking at photographs, watching documentaries of interest, going for walks, dancing and listening to music.
• Offer a small number of choices, this may include visual choices, for example, showing the person two or three different things for them to choose from rather than just giving the choices verbally.
• It may be helpful to offer specific choices, for example, “would you like to go for a walk or something else?” rather than “what would you like to do?”.
• Write information down, including on calendars and as reminders.
• Smile and use open and relaxed non-verbal communication skills, for example, body language and eye contact.
• Face the person when speaking to them.
• Be open to different ways of communicating, not just speaking.
• Use a total communication approach, for example gesturing, drawing, writing, using facial expressions and objects as alternatives or to supplement speech.
• Support the person to express themselves, giving time and encouragement.
• Enable the person to lead the conversation, even if the meaning isn’t clear, observe their tone of voice and gestures.
• Support what you’re saying with visual cues, for example, objects, photos, drawings, gestures or mime.
• Provide one piece of information or one subject at a time.
• Give the person time to talk and to process what has been said to them.
• Listen and watch for non-verbal signals (body language or facial expressions), these will give you information about how the person is feeling and may also provide clues as to whether they are following what you are saying.
• Make the topic you want to talk about clear at the start of the conversation.
• Talk about topics the person with dementia is familiar with and (or) is interested in and that they are reminded periodically what is being talked about.
• Repeat important information if needed.
• Avoid ‘test’ questions, don’t ask questions you already know the answer to in order to test the person with dementia, try and re-frame, for example, “Lydia, your granddaughter, came to our house yesterday” rather than “Can you remember who came to visit us yesterday?”
• Avoid using questions if you can use another form of words instead, for example, “I think that is a good TV programme. It looked like you enjoyed it.”
• Try not to jump in to guess the person’s words or finish their sentences.
• Ask the person how they would like you to help them. For example, “When you can’t find the word, what do you want me to do?” This will differ between conversation partners, depending on their relationship. There may be one strategy that works best but remember it won’t work 100% of the time and it will need to be reviewed every so often to see if it’s still the help the person needs.
• Always include the person in conversation and never talk about the person in front of them as if they are not there as they may understand what you are saying.
• Recognise that the person may not find it so easy to remember specific details but may still enjoy listening to a conversation.
• If the person says the wrong word but you understand the meaning, don’t interrupt to correct them.
• Accept the person’s reality, even if it is different to your own.
• Respect the person’s feelings and experiences, even if you might perceive the same thing differently.
• Try to respond to how the person is ‘feeling’ even if words don’t make sense.