Dementia Care: Communication is All

By , 3:16 pm on

Communication is central to dementia care. It’s successful when caregivers stay calm, connect and pay attention to a loved one’s body language and history.

While people with dementia often have heightened perceptions of emotional tone and body language, their understanding is impaired, ultimately hampering communication.

Picture this: Your husband, who has Alzheimer’s, might respond to the anger and frustration you’re telegraphing by thinking: “You’re upset; I don’t understand what is wrong.  Because you’re scaring me, I’ll struggle if you hold my arm.”

Dementia damages one’s abilities to pay attention, to understand and create spoken and written language, and to store and recall information (memory). Caregivers see a person who cannot learn new things, forgets the immediate past, sometimes uses the wrong words for things, and occasionally responds automatically as though they understand.  Simultaneously, the person with Alzheimer’s may be drifting backward in time and/or be stuck in an emotional track, further reducing communication.

When an able-minded caregiver doesn’t get the message of fear, anxiety, or loneliness, a person with dementia typically responds with agitation and it might show up as rocking or shouting.

These tools ease communication with a person whose ability to send and receive signals is badly damaged, yet still has needs and a will of their own. Communication is at the heart of dementia care.

Engage multiple senses to increase connection.  Approaching her mother from the front, Michelle waves and uses a low, pleasant tone when at an arm’s length away, saying, “Hi Mary, it’s Michelle.” Next, Michelle touches Mary gently on the arm and stablishes eye contact.

Use simple, short and concrete phrases. While many people with middle stage Alzheimer’s can follow visual and auditory cues, they miss 1 in 4 spoken words and process language at slow speeds.  Dementia strips nuance from language, leaving a concrete understanding of words.  On hearing “let’s run out to dinner,” your loved one might try to run. Try, “Mary, it’s dinner time; let’s sit at the table.” (Point at the table.)

Watch body language for clues to feelings. Offering your cold-looking loved one a robe might mean the difference between a peaceful bath and a fight.  A loved one’s routine actions may be communication, too.  One reason for evening agitation or “sundowning,” is excluding a loved one from the evening routine.  Maybe dinner preparations take your mother to a time when she nightly prepared dinner, welcomed a husband home, and monitored a child’s homework.  When you tell her sit and watch TV, she resists because she can’t do her “work.” Give her a kitchen job sorting plastic ware.

Slow down and stay calm; you’ll transmit calm and also be in a better position to read your loved one’s emotions. Asking to “go home” expresses a need for the comfort and purpose of the old days.  Connect with positive assurance, saying, “John, I hear you; this is hard. Let’s go to the kitchen to eat a snack (make an eating motion) and you can tell me about your court room days as a judge.

Use positive phrasing and forget these words: Don’t, Can’t, Why, Remember?  Try “Here’s sugar for your coffee, Dad,” rather than “Dad! Don’t put salt in that!”

Long into their disease, people with dementia retain their desires to connect with loved ones and have emotional and physical needs to communicate. We need to pay attention to receive our loved one’s signals.


Lee Nyberg serves seniors through educational outreach and her company, Home Care Assistance.  Home Care Assistance is North America’s premier provider of in-home senior care.  Our mission is to change the way the world ages.  We provide older adults with a higher class of care that enables them to live happier, healthier lives at home, even with significant health issues. Our services are distinguished by the caliber of our caregivers, the responsiveness of our staff and our expertise in Live-In care. We embrace a positive, balanced approach to aging centered on the evolving needs of older adults. For more information visit our website:


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