How to Communicate with People with Dementia

August 16, 2019
Dealing with a loved one's dementia can be painful and frustrating, as communication can be an enormous challenge due to the effects of the disease on the brain. Read on to discover how to talk to someone with dementia.

Communicating with people with dementia can be complicated. Maybe you’ve experienced this first-hand with a family member or close friend, which means you know how difficult it can be. People who are considered “dependents” (i.e. unable to take care of themselves) are part of a heterogeneous group made up of a range of conditions.

People with Alzheimer’s or other types of dementia fall into this category. Those with severe mental illnesses, Parkinson’s, or brain damage are also dependent on others. In this article, we’ll focus on Alzheimer’s patients.

What is dementia?

There are different diagnostic criteria for dementia. Health professionals mostly use the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The former is designed for clinical diagnosis, while the latter for epidemiological study (Garcia and Olazaran, 2000).

The diagnostic criteria for dementia from the DSM-IV are the following:

  • The development of multiple cognitive deficits manifested by both:
    • Memory impairment (impaired ability to learn new information or to recall previously learned information
    • One (or more) of the following cognitive disturbances:
      • Aphasia
      • Apraxia
      • Agnosia
      • Disturbance in executive functioning (i.e. the capacity for abstract thinking and planning, initiating, sequencing, monitoring, and stopping a complex behavior).
    • The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.
An elderly man's head breaking to pieces.

Alzheimer’s disease

Alzheimer’s disease is the most common cause of dementia, a general term to describe problems with memory and other cognitive functions. It’s a brain illness that affects people’s ability to remember, reason, and communicate.

People used to call dementia “senility”. They believed that it was a normal sign of aging. Now we know that Alzheimer’s and other forms of dementia aren’t a normal part of getting older.

Alzheimer’s causes changes in the areas of the brain that control memory and reasoning. That’s why people with Alzheimer’s have so many problems going about their day-to-day lives, and that’s why communicating with patients with dementia can be a Herculean task.

In spite of all the medical advances of the last few decades, there’s still no cure for Alzheimer’s. However, most people with Alzheimer’s can live for a long time with proper care. This illness tends to affect people over the age of 65, although it can start as early as age 40.

Communicating with people with dementia

Alzheimer’s disease makes it hard for your loved one to understand others or to be understood. It can also make them act in frustrating or irritating ways. In this sense, it’s very important to remember that the disease is what causes their behavior and that they aren’t doing it on purpose.

Trying to communicate with patients with dementia can be really challenging and might put your patience to the test. Consequently, it’s important to learn how to deal with communication problems that might come up when interacting with your loved one.

Patients with dementia.

Strategies to improve communication

People with dementia have problems understanding what people say to them. However, they’re very sensitive to the way people say things. Speaking to an Alzheimer’s patient in an irritated tone of voice can agitate them. A calm voice can comfort them. Thus, try to speak in the most positive way possible.

Avoid talking about reality

Your loved one can become confused about reality and might not be able to distinguish between the past and the present. They might even forget who you are. Although that can be painful, don’t try to make them accept your version of reality. That’ll only cause more confusion and tension.

For example, instead of saying “You can’t call your dad, as he died a long time ago,” say “Your dad probably isn’t home right now, you should call him later.”

Be a calming presence

Your loved one might repeat the same questions over and over again. Although that can be irritating, try to figure out why they’re asking those particular questions. For example, they might be worried about getting to an appointment on time or that there’s no one to take them to said appointment.

Instead of saying “I just said that your appointment is at 2 p.m.,” try to say “Don’t worry, I’m going to go with you to your appointment.”

An elderly man with dementia talking to his doctor.

Use distraction

People with dementia often try to do things that aren’t safe, like leave the house alone. Arguing with them about this can make things worse. Instead, try to distract them with something. It won’t take very long for them to forget what they were planning to do.

If you want to effectively communicate with a patient with dementia, the best strategy is often to change the message. For example, instead of saying “Where do you think you’re going? You can’t leave the house by yourself,” say “Before you go, could you help me with this?”

Communicating with people with dementia requires a lot of patience as it can be psychologically exhausting. Although you might feel anger, frustration, fear, or resentment, don’t worry. All of those feelings are completely normal. If you feel overwhelmed, you should try to find a support group. You should also take some time for yourself so that you can be your best self with your loved one.