If you are finding it difficult to talk to a parent or loved one who suffers from dementia, these following 13 tips may help.
As our loved ones age, it’s not uncommon for them to begin showing signs of dementia.
This can be a difficult time for both the individual and their family members, as they adjust to the changes in their loved one’s abilities and behavior.
It can be challenging to know how to communicate with a parent who has dementia.
The first step is to try to understand what stage of dementia they are in because each stage presents different challenges. For example, in the early stages, your loved one may be able to have conversations and follow simple directions.
However, as the dementia progresses, they may have more difficulty with communication and may become confused or agitated easily.
So, before we go over our tips, let me give you a brief explanation of what symptoms of dementia can be expected in each of the 4 stages of dementia.
How To Talk To Someone In Each Stage Of Dementia
There are 4 stages of dementia:
- Early Stage
- Middle Stage
- Late Stage
- Final Stage
The methods used to communicate with someone in each of these stages does change. Here are some details.
Early Stage Of Dementia
Early diagnosis can be a great relief for both the person with dementia and their family, but it can also be very frightening.
The thought of losing your memory and the ability to think clearly is scary for anyone. The most important thing you can do at this stage is to talk to your parent about what they are experiencing.
It is important to reassure them that you are there for them and will support them through this.
Most people in the early stages of dementia can still live on their own and do most things for themselves. However, you may notice that they are beginning to lose focus as well as ability.
This may lead them at times requiring reminders about tasks that need completing or information needed just then (like knowing the right words to use).
The person with early stage dementia might not know what they are doing or how to do things, but it isn’t because of a lack in brain power.
Instead this is due to the fact that their judgment has been affected by this illness and can lead them into dangerous situations where caregiving help is needed most- now more than ever before!
During this time, friends and family should always stay vigilant; give reminders through notes on sticky notes commonly placed near places where his/her memory may fail.
Don’t be surprised if they happen to fall without warning, or forget to eat a regular meal.
Forgetting to eat is one of the most common problems people with dementia face because they simply forget that they’re hungry- it’s not that they don’t want to eat!
Eliminate multiple choices, provide no more than 2 choices at any one time. (example: Would you like a tuna sandwich or a bowl of soup for lunch?)
Middle Stage Of Dementia
The middle stage of dementia can be terrifying for family caregivers. People in this phase will have trouble understanding explanations and completing tasks, so it’s very important that they stay focused on task at hand with close attention paid towards whatever you’re doing now!
Do not expect them to follow commands that involve more than one step.
The person may find it difficult sequencing tasks due the increased demands on their cognitive processes. They require more physical or verbal cues in order complete these complex operations successfully without making mistakes that could lead them into danger.
The middle stage is also when you may see more aggressive behavior from your loved one. They can become physically and/or verbally aggressive towards you and everyone else.
They may also become paranoid, fearful that others are stealing from them or going to harm them in some way.
In this middle stage, you may also see the sundowning syndrome which is when they become more agitated, anxious and alert during the late afternoon / early evening hours.
When talking to someone in the middle stage of dementia, you will have to continue providing information one step at a time. Your loved one may become non-verbal and instead repeat the same few words over and over again.
Late Stage Of Dementia
In this late stage of dementia, your loved one requires 24 hour supervision. They most likely will not be able to understand what you are saying at all, but can still read your body language and tone of voice.
So, speak as softly as you can but loud enough for them to hear. Crouch down to their eye level and keep your sentences short and to the point.
They will probably not recognize objects, so a fork or a glass will be the same for them. You will most likely need to place your hand over their hand to perform tasks such as eating and drinking.
Keep the environment around them quiet and peaceful.
Final Stage Of Dementia
I helped to treat many patients in this stage in my Occupational Therapy career and the goal at this point is to simply care for them, make them as comfortable as possible.
They most likely do not understand what you are saying but again, may respond to your body language and tone of voice, if they are awake at all.
Physical cueing is the best way to communicate with someone in this final stage of this disease.
13 Tips On How To Talk To Someone With Dementia
- Approach conversations gently and calmly.
- Be as direct as possible (i.e, use names instead of pronouns).
- Don’t keep trying to correct them.
- Avoid open-ended questions.
- Don’t give more than two choices.
- Avoid using baby talk and talking down to them.
- Talk more about the past than the present or the future.
- Use body language and eye contact to help convey your feelings and thoughts.
- You may have to tell or go along with a lie.
- Get rid of environmental distractions.
- If they are bi-lingual, it can help to speak in their native language.
- Be understanding and supportive of their limitations.
- Talk at their eye level.
Having a parent or loved one with dementia can be stressful and overwhelming for them and for you.
After all, it can be heartbreaking to watch your parents struggle with the signs of dementia such as memory loss, difficulty with problem solving and familiar tasks, confusion and much more.
People with dementia aren’t trying to be difficult. They simply may not be consciously aware that they’ve changed, which is part of the disease. Dementia patients reflect their view of the world, which means they might get angry about little things, like cold coffee, being told they can’t do something or feeling coddled. They may also feel like they are a “hostage” if they are unable to participate in activities they used to do, like driving or writing checks.aarp.org
Of course, some dementia patients do become non-verbal, especially in the late stage of their disease. Oftentimes this requires family caregivers to learn new communication strategies.
They must be more demonstrative with their facial expressions and body language and, of course, must be more patient when trying to communicate.
It takes a little time for friends and family members to get used to the new communication skills needed when talking to a loved one with dementia, but it’s worth it in the long run.
If your loved one is having trouble understanding what you are saying, these communication tips should help.
1. Use a Calm and Gentle Voice
Focus on keeping a calm and gentle voice whenever you’re speaking to your loved one with dementia. Avoid raising your voice, no matter how angry or frustrated either of you becomes during a conversation.
As much as you don’t want to talk down to your parent, you will need to change how you speak to them and your tone of voice. After all, the way you talk to somebody is just as important as what you’re saying to them.
Keep in mind that they have memory problems – they most likely will not remember your conversation, so don’t expect them to.
You might also want to take a little time to yourself to cool off when you sense that you’re getting frustrated. Don’t be shy about seeking out support groups or respite care. It helps no one if you are burned out.
Most importantly, remember that this is out of your control. No amount of anger or reminding your parent of a fact will help the situation.
2. Be Direct
Be very specific in the words that you use.
When speaking to someone with dementia, avoid using pronouns and vague terms such as “she went to the park” or “it’s over there”. Instead replace them with “Diane went to the park” and “the fork you need is on the counter top next to the toaster.”
Dementia can make it very difficult for your elderly parent to follow conversations the way they once did. They might become a little distracted or lose the plot in the middle of the story.
They may even keep asking you questions while you are speaking. This often happens because they have lost track of your story – even if you’ve only been speaking for a minute.
That’s why it’s more important now than ever that when you talk to a parent with dementia that you speak with simple words. Give them your full attention, use short sentences and speak quite clearly.
- Don’t tell long stories or ask long questions – your loved one might not be able to follow them.
- Avoid details such as what someone wore or ate. If the detail is not important – don’t mention it.
- Make short and precise statements.
- Avoid pronouns. If you are speaking about your sister Diane, keep saying the name Diane instead of “she” or “her”.
- Make eye contact and face them as you speak.
A few tricks I learned as an Occupational Therapist was…
- When speaking to an elderly loved one with dementia, it’s a good idea to spend 80% to 90% of the conversation on THEM – on what THEY want to talk about versus what you want to talk about. This not only gives your loved one some control but allows them to talk about what they know. In other words – LISTEN to them more than TALK to them.
- Keep your voice calm even if your mom or dad begin yelling or over-reacting. Hard to do sometimes, I know, but very important.
- Rephrase your question/comment in different ways instead of repeating it. I have witnessed so many adult children repeating the same words over and over and over again wanting desperately for their parent to understand them when the truth is, that just was not ever going to happen.
- Redirect their attention to something else if the current conversation seems to distress them.
- It’s worth repeating – LISTEN to them more than TALK to them.
3. Don’t Keep Trying To Correct Them
When I worked as an Occupational Therapist, I had to talk to many family members about trying to correct their parent or loved one when they got details, names or events wrong.
The family member would try to tell their parent, “No, it wasn’t Aunt Suzy who got a dog, it was Aunt Mary.” Or, No, Dad, Bill wasn’t the one who got you this sweater, it was Jim.”
All this did was upset and confuse their family member! At the end of the day, does it really matter who did what or who bought what…or whatever the issue is?
Just accept that your parent is thinking about Aunt Suzy or Bill when they mention them and let the rest go. You and they will be the more peaceful and happier for you doing this.
4. Avoid Open-ended Questions
Don’t ask open-ended questions. They can be too difficult for someone with dementia to think through or answer.
Imagine trying to understand the nuances of a question like, “Mom, are you in the mood for Italian food? What do you want me to fix for dinner?”
In order to answer, Mom has to think about and filter through potentially numerous possibilities, and then accept or discard them as they occur to her. That can be overwhelming for someone experiencing cognitive difficulties.
Instead, ask your parent short and precise questions: “Mom, are you cold? Would you like to put on your sweater?”.
5. Avoid Giving Them More Than Two Choices
Avoid questions where there are too many decisions for someone with cognitive issues to follow.
Instead give them a choice of two (i.e., instead of “what would you like for lunch?”, ask “would you like a tuna sandwich or chicken soup for lunch?”).
6. Don’t Talk Down to Them
Respect that your elderly parents are still adults.
Even though you are now your parent’s caregiver, that doesn’t mean that you should be speaking down to them in any shape or form.
Speaking to your mom or dad as if they’re a child or by using baby talk, it can be quite embarrassing and degrading for your parent.
They might not understand everything that you’re saying, but they’re still an adult and are trying their best to hold a conversation with you.
7. Talk More About The Past
Dementia often robs someone of their ability to remember new and recent events. But, most seniors retain their long term memory to some extent.
So, if you can keep conversations to past events, you both may have a more pleasant experience. Some examples of what to talk about are…
- What games did you enjoy playing when you were younger?
- Do you remember your first girlfriend / boyfriend?
- What did you and your friends do together as teenagers?
- Was your mother a good cook?
- Did you have a favorite cereal growing up?
Anything that you can ask them or talk about that was in their past can help to give them a sense of control instead of feeling that they are unable to answer you because they just can’t remember what they had for breakfast that morning.
8. Consider Your Body Language
Even if your loved one with dementia may not understand your words, they may understand your body language. Also, eye contact while you are speaking can help as well.
Humans communicate with words, but nonverbal cues and body language are perhaps just as important.
When it comes to communication, the belief is that 55% of communication is body language, 38% is the tone of voice, and 7% is the actual words.awareseniorcare.com
Even if your loved one with dementia may not entirely understand what you’re saying, they might be able to read your body language and pick up on what’s going on.
Focus on how you’re carrying and expressing yourself during conversations.
If you’re happy when telling a story or asking a question, be sure to smile or laugh when it’s appropriate. If you want to comfort your parent try a gentle touch by holding their hand or giving them a hug.
Physical contact can be very important for a person with dementia – depending of course on that particular person.
It might also help to use nonverbal communication, such as gesturing and pointing draw their attention to something you’re talking about. This can be a powerful tool to help your parent to associate what you’re talking about with a physical object.
Again, keep direct eye contact with them. Face to face communications are usually the best way to keep a conversation going with someone who suffers from dementia.
9. Therapeutic Fibbing
Telling an outright lie or going along with a lie is something that many caregivers of older adults with dementia often have to do.
“Therapeutic fibbing is lying, or bending the truth, in order to avoid increased agitation from a person with dementia.”iona.org
The intention behind the act of lying to someone with dementia is often to avoid upsetting that person with reality which oftentimes causes unnecessary distress.
Paying close attention to the memories someone with dementia is talking about instead of correcting any untruths can help everyone involved.
10. Get Rid of Distractions
Along with dementia comes a struggle to maintain focus amidst environmental distractions.
In fact, it might be impossible for your mom or dad to focus 100% when you’re talking to them.
That’s why you want to make sure to get rid of all types of audio and visual distractions if an important conversation needs to be had with your elderly loved one.
That can be anything, from turning off the television or radio to going to a private room where there are fewer people.
Give them the chance to focus on you and exactly what you’re saying if it’s really important.
But remember that there’s only so much you can do to draw your parent’s attention and focus.
Also keep in mind that they will have good days and bad days, so don’t assume that turning off the television is all your loved one needs to focus on what you’re saying.
Leave conversations for a new day if they can wait.
11. Speak In Their Native Language
The Alzheimer’s Association reports that, depending on the stage of dementia, older people may revert back to using the language they grew up speaking.
For example, my mother was born in Italy and grew up speaking Italian. She learned to speak Spanish when we lived in Venezuela and then she learned English when we moved to the United States. If she had been diagnosed with Alzheimer’s disease or dementia, she might easily have forgotten how to speak English and possibly Spanish as the disease progressed and revert back to Italian.
If this is true of your parent and you speak the language of their childhood, doing so can be a great way to overcome communication problems.
12. Be Supportive
Supporting your loved one is the most important thing you can do to help them through this difficult time.
A loss of memory and slowed thinking can be quite embarrassing, so the last thing you want to do is to point these issues out. Instead, praise the skills that they can do.
Another way to be supportive is by placing less stress on the details.
In other words, it’s okay if your loved one doesn’t remember all the minor details of an event or a person or if they have trouble understanding even the simplest things. Constantly trying to correct them will not only be embarrassing for them but also frustrating on your part.
13. Talk At Their Eye Level
Towering over someone can be intimidating (and also hard on their neck if they have to keep looking up at you!). And it’s easy for someone to be distracted if you’re trying to hold a conversation, but are facing away from them.
It’s better to be at eye level when talking with a parent who has dementia. That way, you can take their hand and look them in the eye.
It will be easier for you to know that they are engaging with you and easier for them to read your subtle facial cues.
Through it all, remember to be thankful for the good times and conversations that you do have with them. Try to be open to any conversations they’re willing to have and simply enjoy the fact that you are communicating.
A dementia diagnosis can be quite frustrating – both for people with dementia and their adult children and family.
After all, it can be a little overwhelming to take over as your parent’s caregiver. That’s especially the case when your parent struggles with memory difficulties or seemingly simple daily functions like bathing and cooking.
It’s natural to get angry, but it’s important to mindfully manage what you do with it. One reason is that people who have dementia are sensitive to your moods. If they feel afraid of you, for instance, that could have a negative impact on the caregiving and care-receiving relationship that is ideally rooted in trust.iona.org
It might take a long time, but it’s important that you work on controlling your frustration and anger.
You need to understand that most tasks will be a little more difficult for your loved one from this point on.
Focus on the positive aspects of your relationship and learn to lower your expectations for what your parent can do for themselves.
But, remember that this is also extremely frustrating for them.
Once independent, your parent now has to depend on their own child to make it through the day. There’s a significant loss of freedom, and your parent might even be reluctant to accept your help.
Make sure you’re staying calm and understand that your parent isn’t purposely doing or not doing anything to inconvenience you.
Some Resources For You
Here are some links to some books that may be helpful for you and your loved one.
When your parent or loved one receives a diagnosis of dementia, your family relationship will change forever. You have to be willing to change how you communicate with your parent as they cope with this new diagnosis.
The most important thing you can do for yourself and your loved one is to be as calm and direct as possible and avoid getting frustrated when your parent becomes confused.
Remember, this condition is out of your their control, and it’s important that you’re supportive during this tough time.
- Alzheimer’s Society: Tips: communicating with someone with dementia
- A Place for Mom: Communication Strategies for Dementia
- Alzheimer’s Association: What Is Dementia?
- Family Caregiver Alliance: Dementia, Caregiving, and Controlling Frustration
- Very Well Mind: Understanding Body Language and Facial Expressions
- WebMD: Alzheimer’s Brain Can’t Block Distractions
Frequently Asked Questions
What’s the difference between dementia and Alzheimer’s?
Alzheimer’s is a specific, degenerative disease of the brain. Dementia, on the other hand, is a general term for a group of symptoms. There are many types of dementia and a number of conditions that cause them.
How do you tell your mom she has dementia?
The best way to talk to a parent about their dementia diagnosis is to be direct, but loving and reassuring. You can tell your mom that she’s been diagnosed with memory loss, but that you’re there to support and help her. Depending on your parent’s situation, you might even consider using the words “dementia” or “Alzheimer’s” if they apply.