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How Your Loved One’s Communication Abilities Change as Dementia Progresses

Alzheimer’s disease and other forms of dementia can progress over several years with their symptoms worsening over time. As the condition progresses, you may find it more and more difficult to talk with your loved one. In the beginning, people with dementia will be able to carry on normal conversations but may forget a word or use the wrong words. Or they can have trouble resuming a conversation after they’re interrupted. Eventually dementia can cause mood swings and even change a person’s personality and behavior.

This blog post will offer dementia communication strategies to help you engage with and support your loved one as they deal with their memory problems.

Communication Changes as Dementia Progresses

As your loved one’s dementia progresses, the resulting memory loss can become upsetting and frustrating for you and them. But with a little encouragement and by using these dementia communication strategies, including understanding body language and other forms of nonverbal communication, you can help your loved one overcome some of the barriers to communication with dementia.

Tips for Communicating During Different Stages of Dementia

Communication with a person with dementia requires patience, understanding, and compassionate listening skills. The suggestions below can help you continue to interact with your loved one in meaningful ways.

Communication during early-stage dementia

In the early stages of dementia, your loved one can still engage in meaningful conversation and social activities. But they may find they repeat their stories, feel overwhelmed by big groups of people or excessive stimulation, or have difficulty finding the right word. Keep these early-stage dementia communication strategies in mind:

  • Because the disease affects everyone differently, don’t make assumptions about your family member’s ability to communicate because of a dementia diagnosis.
  • Be sure to include your loved one in conversation.
  • If you have questions for your family member, speak directly to them rather than their caregiver or another family member.
  • Take time to listen to your loved one express their thoughts, feelings and needs.
  • Give your family member time to respond. Don’t interrupt unless they’re requesting your help.
  • Ask your loved one what they’re comfortable doing and what they need help with.
  • Talk with them about how they prefer to communicate: face-to-face conversation, email or phone calls, etc.
  • It’s OK to laugh. Often humor lightens the mood and makes communication easier.
  • Stay engaged. Your honesty, friendship and support are important to your loved one.

Communication during middle-stage dementia

The middle stages of dementia can last for several years. As the condition progresses, your loved one will have greater difficulty communicating. Middle-stage dementia communication strategies include:

  • Engage your family member in one-on-one conversation in a quiet space that has minimal distractions.
  • Speak slowly and clearly.
  • Maintain eye contact. It shows you care about what your loved one is saying.
  • Give your loved one plenty of time to respond so they can think about what to say.
  • Be patient and offer reassurance. It may encourage your family member to explain their thoughts.
  • Ask one question at a time.
  • Ask yes or no questions. Instead of asking, “What would you like to drink?” say, “Would you like some coffee?”
  • Listen and try to find the meaning in what your loved one says. Repeat what was said to clarify.
  • Avoid arguing. If your family member says something you don’t agree with, let it be. 
  • Offer clear, step-by-step instructions for tasks. Lengthy requests may be overwhelming.
  • Show what you want done instead of telling.
  • Written notes can sometimes be more helpful than spoken words.

Communication during late-stage dementia

The late stages of dementia may last from several weeks to several years. As the condition advances, the person may rely on nonverbal communication, such as facial expressions or vocal sounds. Late-stage dementia communication strategies include:

  • Approach your loved one from the front and identify yourself.
  • Encourage nonverbal communication. If you don’t understand what your family member is trying to say, ask them to point or gesture.
  • Use touch, sights, sounds, smells and tastes as a form of communication with your loved one.
  • Consider the feelings behind words or sounds. Sometimes the emotions being expressed are more important than what’s being said.
  • Use appropriate physical contact — such as holding hands or offering a warm hug — to let your loved one know you are there and offer reassurance.

Discover Specialized Care with a Personal Touch

At Lakewood, our Cornerstone Memory Care program uses seven guiding principles to help your loved one experience a vibrant and engaging life, including:

  • Purposeful living in a comfortable, safe environment
  • Compassionate, specially trained team members
  • Life story: learning your loved one’s preferences, lifelong routines, wishes and history
  • Meaningful relationships and belonging
  • Resident and family engagement
  • Ability-focused care
  • Vibrancy, faith, wellness and community

To learn more about how we can support you and your family member, contact us here.