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Communicating with Individuals who have Dementia

This section will give you some insight on how to communicate with individuals who have dementia. It is important to realize that you need to face this challenge from the point of view of the individual with the cognitive impairment. This will be difficult, as your expectations and usual ways of communicating will interfere. However, learning these new communication skills will result in better management of the situation, and, more importantly, will improve the individual's quality of life.

Let's start by looking at an example. Click the icon below to view a communication scenario. While viewing note the strategies used by the caregiver in this situation.

Communication Strategies

  • Orientation
  • Environment
  • Body language
  • Concrete words
  • Simple language

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      F. Female Caregiver (Rose)
      E. Elderly woman (Mrs Christie)

      F. Well, Youíll just have to be patientÖ (talking to an elderly man sitting and waiting)

      E. Itís not here. (approaching elderly woman)

      F. ÖItís almost done, Mr Beck. (assuring the elderly man)

      F. Joe, could you please take over here if I help Mrs Christie.

      E. I donít know where it is. I gotta go now. Itís not here.

      F. Mrs Christie. Iím Rose. Let me help you. Have a seat. Iíll stay with you.

      E. Itís not here. I gotta go now. Itís not here. I canít find it. It isnít here.

      F. Have a seat. Itís alright.

      E. I canít find it. Itís notÖIÖI gotta go now.

      F. Mrs ChristieÖIs there something in your purse that you canít find?

      E. Yes. Not here.

      F. Is it something you need now?

      E. No. Not here. Gotta go. I canít. Go home.

      F. Is it something at home?

      E. Home?

      F. Is it your keys?

      E. Keys. Keys. No. No.

      F. Mrs Christie, may I help you. May I look in your purse.

      F. Here are your keys.

      E. Arrr, Keys!

      F. Iíll help you anytime Mrs Christie.


      • Approach individuals so that they can see you (don't start speaking until you have eye contact).
      • Maneuver yourself so that you are at eye level with the individual.
      • Observe the individual for signs of understanding or confusion. If you are concerned about confusion restate the message clearly.

      • Choose the right environment.
      • Reduce noise and other stimuli as much as possible to maximize the individual's ability to focus and communicate.
      • Remember that people suffering from dementia also may suffer age-related changes in hearing and eyesight.
      • Make sure you can be heard and seen.

      Body Language
      • Even after individuals with dementia can no longer speak or understand speech, they often have preserved ability to understand non-verbal signs. Use these non-verbal channels of communication.
      • Communicate through touch (once trust has been established), facial expression, posture, head movements, eye contact, gesture and position relative to the person.
      • Speak in a low audible tone of voice with animation, intonation and gesture.

      Concrete Words
      • Use concrete language. Use terms that are not ambiguous.
      • Connect the word with the real object as much as possible.
      • Don't use metaphors and analogies because people with dementia have difficulty to think in the abstract.
      • Talk about things you can see or actual things that are happening.
      • Be direct and specific. Say "I will talk to you at 3 p.m." rather than "I'll see you later."

      Simple Language
      • Simplify your communications. Use short simple sentences or questions.
      • Use proper names that people recognize and are familiar with. Avoid "him" and "her".
      • Ask one question at a time.
      • Give one direction at a time.
      • Ask "yes/no or either/or questions whenever possible.
      • Give the person time to think and respond.
      • Avoid displaying anger and impatience.

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