How to Talk to Someone Who Has Dementia

interacting with an elderly woman with dementia

Dementia doesn't always look like the end of The Notebook. Your loved one won't necessarily remember how to play piano or not recognize their kids.

It can be more subtle or much worse. Dementia is a disease and it's as heart-wrenching to watch as any other. It's no different than something someone visually suffers through.

If you have a loved one with dementia and are trying to understand how your lives will change, read this communication guide. We'll give you tips and tricks to making both of your lives as easy as possible.

What is Dementia?

First of all, dementia is a category of diseases, not just one. It's an umbrella term for damage to the brain that causes memory loss.

You've heard of it most as Alzheimer's, which is mixed or vascular dementia. People get this from lack of blood flow to the brain.

Alzheimer's starts slowly and gets worse over time. Vascular dementia happens in noticeable steps, like after a stroke.

Dementia with Lewy Bodies is a third type, not caused by blood flow but lack of brain chemicals. Things like acetylcholine and dopamine communicate messages across the brain.

When you have this type of dementia, connections between nerve and brain cells weaken and die.

Dementia with Lewy Bodies is most common in Parkinson's patients, but anyone can get it.

The last main type of dementia is Frontotemporal, which you may have heard of as Pick's disease.

Instead of the way brain pathways die off in other types, frontotemporal rearranges brain pathways.

Brain connections that used to connect each lobe die, then the brain tries to reconnect them. The dead connections cause the frontal and temporal lobes in the brain to shrink.

If you hear of dementia in young people, it's usually this type. It's diagnosed as early as age 45.

More Than Memory

Whoever your loved one is, they'll lose more than their memory with dementia symptoms.

Along with brain function related to memory, dementia causes other cognitive impairment. This means they could have trouble concentrating or thinking through a task.

Sometimes they get lost doing things they've done their whole life, like getting stuck following a recipe.

Communication wise (later), it's hard for people to come up with the right word or carry on a conversation. Their brain may race around trying to find a word or they'll attack themselves mentally for forgetting.

Speaking of psychological, people with dementia get very upset with themselves. In more advanced cases, they don't always know how to show it.

This could mean your loved one is in a bad mood more often, is quicker to react emotionally, or withdraws. Imagine living your whole life and then realizing you can't do something you've always taken for granted. You'd be grumpy too!

This is hardest in the beginning since they'll become less emotionally aware as the disease progresses. See if their memory care community has counseled and try to set that up.

You may need counseling as well. It's hard to see someone you love suffer! Especially if they get to the point where they don't remember who you are to them.

Communicating With a Dementia Patient

When you are talking or engaging with your loved one, keep the above facts in mind. Try to remember that this is a disease they can't do anything about and leave frustration at the door.

It's okay to feel overwhelmed or sad after talking with them, but don't avoid them. They need your love now more than ever.

Arm yourself with these tips so you can be a better friend/spouse/family member to someone with dementia.

1. Eye Contact

Looking in someone's eyes when you speak is common decency, or it should be. It shows people that you're listening and care what they have to say.

It's also a way to gauge the attention or interest of a person. If you're explaining something to anyone (not just a dementia patient) and their eyes glaze over, you're wasting your time.

Find a different way to say what you're saying or help them re-engage.

2. Re-engage Often

With a dementia patient, re-engage them gently. Their mind may have drifted off in thought or they could no longer pay attention.

Don't say something like "Hey! Pay attention!". That's like telling someone with whooping cough, "Hey! Don't cough!" It's not in their control.

Instead, touch them gently or say their name. A gentle hand touch or squeeze if you're holding hands already will get their attention.

Start over from where you noticed them drift off, but don't repeat yourself exactly.

3. Speak Slowly

One of the reasons people with memory issues drift off is because they can't keep track of what you're saying. Lots of us don't think we speak fast, but to them, we do.

Think about your first time listening in a foreign language. You can't tell the words apart when they speak at normal conversational speed.

You don't have to wait seconds between each word, but make an effort to slow down. Take breaths between sentences if you need help.

4. Use Short Sentences

Like speaking too fast, it's hard for people to understand when you use complex sentences. They'll get lost and you'll lose their attention.

You want to speak to people with memory problems in short sentences.

Instead of saying, "Hey, Grandma I'm so happy to see you! How was your day?" break that down into three parts.

Hey Grandma, it's (your name if necessary). Let them say hello. I'm so happy to see you, etc.

Giving them more time to process each statement will keep their attention and help them not get frustrated with themselves.

They'll show you the pace they need. Watch their eyes and their facial expressions. Since all types of dementia get worse gradually, this can change.

Ask their caregiver if they're slower than usual or having a bad day.

5. Stay Happy and Calm

When someone's brain doesn't work the way it used to, it's scary for them. Hearing people yelling or speaking loudly or angrily will confuse them.

Even if you're more frustrated or hurt than you've ever been, don't let your voice show it.

6. Don't Point Out Memory Loss

It can be tempting to tell someone, "we just talked about that, remember?" We're not used to repeating ourselves and it's frustrating.

In daily life, having to repeat ourselves means the person wasn't listening. This isn't the case for your loved one.

If they ask the same question for the third time in an hour, answer it the same way you did the first time. At early points, they may realize they've asked that already when you answer again, but only early on.

In some cases, they'll get frustrated with themselves when they realize they're asking again. Don't let them beat themselves up about it.

If they ask "Did I already ask that?" you can answer honestly but don't spend time on it. Move on to something else.

For example, "Yes, but I forgot to tell you their names". Keeping the conversation moving minimizes the time they can dwell on bad moments.

7. Understand Bad Days

Dementia patients have bad days, like anyone else with a disease. Some days they may seem like 100% their old selves and you'll get your hopes up.

One good day doesn't cure someone, as heartbreaking as it is. If you get one of these days, treasure it. You're lucky to have their non-diseased selves shining through.

If you get a very bad day, don't think it's something you did. You wouldn't blame yourself if someone with cancer wasn't feeling well - it's the same thing.

Understand that on a bad day, they may be in a bad mood or not want to socialize. You can tell them you love them and leave them alone or hang out with their grumpy mood.

Don't tell them they're being one way or another - they probably know it. If they say something hurtful, take it the way you would from a child, like they don't know better.

8. Be Patient

Watching someone you love brain die slowly is terrible. It's one of the most heartbreaking and long dying processes that there is.

It's normal to feel like they're not the same person or that they're gone before they're gone. Try not to let them catch on to these feelings.

Imagine how terrified they are inside their head and be empathetic. They're still the person that made you laugh until you cry or put your band-aids on, deep down.

If they're your parents, view this as an opportunity to give back to all the care they gave you.

This is your time to make up for all the mean things you said as a teenager and be as patient with them as they were with you.

Love Them Through It

When you communicate with someone with dementia, be clear, slow, loving and patient. Leave your gotta-get-things-done attitude outside and spend time with them.

Even if it means just holding their hand while you watch a movie. You'll have to change the way you relate, but you can do it!

For other guides on hard things to do or learn, check out our archives. We put out content all the time and want to make your lives easier.

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