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How to Tackle Dementia’s Communication Challenges

September 20, 2018

Dementia in general (particularly Alzheimer’s, its number one cause) wreaks havoc on day-to-day skills we take for granted — not the least of which is our ability to communicate. Challenges in word recall, overall forgetfulness, and the agitation that can result are all tough on patients and caregivers alike; Dad’s increasing inability to process and converse can be disorienting and alarming, sparking uncertainty over how to approach the next interaction. If you’re facing this particular challenge with a parent or loved one afflicted with dementia, here are some guidelines for overcoming difficulties in everyday conversations:


  • Try to relax and think positive: Feeling apprehensive is normal – acting like it will only reinforce tension and potential awkwardness. Practice entering each interaction with relaxed body language and a positive tone.
  • Eliminate distractions: Dementia sufferers are easily thrown by noise and commotion; turn off the radio or TV, create a quiet space, and choose a place to sit that allows you direct eye contact with Mom and helps her focus easily on you.
  • Speak simply and clearly, asking one question at a time: State yourself directly and plainly, using names instead of pronouns. When asking questions, frame them as “yes” or “no” rather than open-ended. So instead of “what would you like for a snack?” ask “would you like some cheese and crackers?”
  • Give visual cues for tasks: If Mom needs to brush her teeth, demonstrate each step through pantomime instead of telling her what to do. Whatever the task, make sure to break it down into simple steps, and take it slow.
  • When things get challenging, regroup and redirect: People with dementia can get easily frustrated, whether trying to come up with language or do what used to be a simple task. If Dad gets angry or worked up, don’t take it on; acknowledge his feelings and then change the subject. “Dad, I see you’re upset – I’m sorry you feel frustrated.” Then ask him to help you with a new task, or suggest a walk, or a drive to a favorite place.


  • Correcting and convincing. People with dementia will experience confusion, even paranoia, and convince themselves of things that have not actually occurred. A misplaced article of clothing, for example, might be attributed to a thieving home health aid. Don’t try and convince Mom that she’s wrong; instead, reassure her that the people helping her love and support her. Reinforce the positive and change the subject.
  • Taking the bait: Dad’s dementia may make him contrary at times – even combative. Bite your tongue and leave his comments where they lie. Treating him like the old dad you always knew will only fuel his frustration and agitation. Take a breath, regroup, and reset.
  • Communicating with Mom through a surrogate: If Mom has a home health aid or other support staff assisting her, it can be tempting to just speak to the professional to move more quickly. Instead address Mom directly and respectfully, and give her the opportunity to answer for herself.
  • Speaking for Dad: It’s OK to gently suggest a word or two if Dad’s struggling to articulate a thought. But take some breaths and give him time – don’t rush him or try and speak over him. Instead offer patience and reassurance and give him time to try and express what he’s trying to say.
  • Getting discouraged: Although any form of dementia is progressive, there will be good days along with the bad. Try and take the long view and do your best to ride out the tough moments, knowing there will be rewarding interactions as well.

For more helpful communications strategies, head to Alzheimer’