An older man and woman sit on a picnic blanket and look out over a rolling green landscape.

Dementia and other age-related diseases like Alzheimer’s can impede our ability to communicate with loved ones. Not only is it frustrating when you feel unable to convey a message, but this problem can also be extremely saddening, as loss of communication weakens our relationships. When this communication is lost with a close friend or family member, the effect can be downright painful.

Fortunately, there are effective tactics you can implement and use on a daily basis in order to better facilitate discussions with an individual with dementia. In this article, we’ll review more details about the relationship between communication and dementia, as well as the methods that can ameliorate disruptions in connecting with those who are affected.

Dementia Changes the Way You Communicate

Dementia is a progressive neurodegenerative disease which means that the condition kills brain cells and gradually gets worse over time. In addition to loss of major memories, both short and long-term, those affected by dementia will also lose the ability to access the parts of their brain that are responsible for language formation and processing. This loss of the ability to comprehend speech and to speak is called “aphasia.”

Differences in Communication Between Stages of Dementia

Depending on the stage and severity of dementia a patient is in, their communication abilities will be correspondingly affected. 

Early-stage dementia is characterized by mild difficulty in focusing attention on conversation. The patient may have trouble remembering certain words and need help to recall them. They might try to pass it off as “no big deal” or try to hide or compensate for the problem by speaking less or more than they usually do, even if they repeat themselves. 

Middle-stage dementia and Alzheimer’s are characterized by all of the initial symptoms, though in this stage they are exaggerated and more severe. When watching TV/movies or reading a book, a patient may have difficulty following along with the subject material. When writing and speaking, grasping for the right words will become increasingly common, so the patient may invent new words or use replacement words that do not make logical sense. They will have trouble correctly following instructions or directions to a location. Lastly, their anxiety around speech may cause them to rely more on gestures than verbal communication.

Late-stage dementia can be identified by an even greater loss of vocabulary and recall of details including names of loved ones and important locations like one’s home address or city. At this stage, a patient may babble or ramble incoherently, talking in sentences that signify little to nothing. They will lose most or all of their ability to follow storylines, news reports, directions, and other kinds of information reliant upon semantic processing.

End-stage dementia and Alzheimer’s is usually characterized by extreme difficulty or complete loss of the ability to speak and understand other’s speech. At this point, gestures will probably replace verbal communication entirely.

Coping with Dementia-related Communication Problems

Progressive neurodegenerative diseases are one of the most painful conditions to watch a loved one endure. Not only is it difficult on them, but it’s significantly taxing for you too, as you might feel helpless being unable to stop the progression of the disease. In order to feel more in control of the out-of-control situation and to make the most of your efforts to connect, try implementing these communication methods with your loved one.

When You Speak

When you are speaking to your loved one, be aware of the words you use. Simple language is better than an advanced vocabulary. Similarly, if the affected individual is bilingual or speaks multiple languages, use the language they learned first in life. Keep your subject matter on a topic-by-topic speed, only discussing one thing or subject at a time. Be sure to enunciate your syllables to make the words better understood, and if necessary, introduce yourself before you begin speaking. 

You may want to comfort your loved one as much as possible, but avoid using baby talk or infantilizing them in any way. The disease is not an indicator of declining maturity or intelligence, and you don’t want to speak in a way that makes them think in terms of such misconceptions. In the same way you monitor the tone of your voice, pay attention to the way you phrase certain ideas or memories. For instance, do not constantly ask if they “remember” an event or occasion, but instead reminisce about the details to try to help them visualize a memory, even if it doesn’t fully come back. 

Lastly, be patient and positive with your loved one. You may need to repeat yourself or explain things in a different way, but as long as you remain calm and in good spirits, this will increase the likelihood of the conversation’s success. 

When You Listen

Just as important as speaking to an individual with dementia is the willingness to listen — and listen actively. Be patient as you give them time to respond to your words and questions, and be willing to repeat yourself if necessary. Give them encouragement to continue speaking, letting them know you value their opinion and words and would like to hear what they have to say no matter what it might be. If you disagree with something they do or say, try to change the subject rather than getting upset or calling them out for their “mistake.”

Lastly, use the resources around you to find more inventive ways of communicating. From pointing at physical objects to creating art to moving with specific body language, your loved one can give you many communicative signs not associated with verbal interaction. You just have to know to look for them and be willing to think outside the box.

How to Do More 

Words will eventually become ineffective when communicating with a loved one with dementia. For this reason, it’s crucial to find alternative ways of interacting that create connections and meaning, even if it’s not to the same degree of closeness that you wish it was. Gestures, expressions, eye contact, and other kinds of physical actions will be extremely important as the disease progresses. If you’re ever unsure of what to do next, you might be astounded to see what a simple smile or hug can do for your loved one.


Dementia and Alzheimer’s disease are profoundly challenging conditions, both for the patient and for the loved ones in their life. If you need assistance with senior living or respite care, the compassionate professionals at The Heritage are here to help.