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Communicating with Your Loved One as Dementia Progresses

A woman sits on the couch between her elderly parents and they look at a photo frame together

It’s heartbreaking to watch someone you care about struggle with memory loss from Alzheimer’s disease or another form of dementia. As the condition progresses, communication challenges are to be expected, but you may not be prepared for how these changes can affect your relationship and day-to-day life for your loved one. Taking steps now to explore ways to navigate dementia communication barriers will be helpful.

Sometimes, the best ways to maintain a close connection shift from one day to the next. As your loved one moves through the stages of dementia, your approach to communication may also change. Adjusting your own verbal and nonverbal communication style may play an important role in helping your loved one convey their thoughts and needs.

How Dementia Affects Communication

Having difficulty with forgetting words or following conversations is often one of the first signs of Alzheimer’s disease or another form of dementia. Over time, the condition takes a serious toll on a person’s memory, cognitive abilities and communication skills. A person with dementia may have trouble finding the right words to express their needs, and feelings of frustration when trying to communicate may intensify. Eventually they may lose the ability to speak and understand speech. 

Understanding the stages of dementia and learning how to communicate effectively can help you maintain a loving and supportive relationship with your loved one over time.

Addressing Communication Challenges by Stage

Early Stage

You may notice small changes In the early stages of dementia. For example, a person may have trouble concentrating on a conversation or losing their train of thought. They may forget words when talking or writing, and you may notice some repetition, such as telling the same story again and again or asking a question repeatedly. In this early stage, a person with dementia may be aware of what’s happening and try to downplay their mistakes.

Be inclusive. People with dementia may avoid social situations as they become aware of their limitations. Finding ways to keep them engaged can help keep communication skills sharper for longer. Being clear and deliberate in the ways you communicate can help. Instead of having a conversation from across the room or in a group setting, speak directly to your loved one at a time and place free from interruptions. 

Remove barriers. Focus on the ways you can make communicating with your loved one easier. Arrange furniture or chairs so your loved one can easily see your face and hear your voice. Eliminate distractions like a TV or radio, and minimize any unnecessary phone alerts or notifications. If you’re struggling with how to talk to someone with dementia on the phone, find out the best time of day to call when your loved one has the most energy and focus.

Moderate Stage

During this stage, your loved one may have more difficulty keeping up with a conversation or following the storyline of a TV program, movie or book. They might forget the names of people, places and things, or they might use made-up words to replace forgotten words. Following directions may become more difficult, and you may see your loved one using hand gestures to express what they want.

Speak slowly. Make it a habit to speak slowly and maintain eye contact as much as possible. Clearly enunciate your words, and keep sentences and stories brief. Try to avoid complicated requests and ask questions that require only simple yes/no answers instead.

Offer support. Remember that your patience and encouragement may help your loved one feel more confident expressing themselves. Resist the temptation to correct or interrupt when they say things that aren’t true or didn’t happen. Instead, listen closely for clues about what they might be trying to express, and offer affirmation and acknowledgement that you’re there to be supportive. 

Severe Stage

As the condition progresses, your loved one’s communication may be limited to basic conversation and instructions. Their vocabulary continues to diminish, and they may forget loved ones’ names and other personal details. You may observe worsening confusion, rambling or nonsensical talk at this stage.

Use nonverbal cues. Using body language can be increasingly effective as verbal language becomes more restricted. You can also engage the senses to help communicate through touch, taste, smell, sight and sound.

Share emotion. Even when you can’t understand the words a loved one is trying to express, it’s still possible to understand the emotion or meaning behind the words. Sometimes simply being present speaks volumes.

End Stage

Speaking and responding may be limited to nonverbal expression only in the end stage of Alzheimer’s disease or dementia. A person in this stage may have little to no ability to comprehend language.

Offer reassurance. Holding a hand or patting a shoulder while you visit can be comforting. Watch for body language to ensure your loved one is receptive to this form of communication. Staying calm and maintaining an upbeat tone as much as possible may be helpful for both of you.

Find Support for Your Loved One

Learning to communicate with your loved one while they go through the different stages of dementia can be taxing — mentally and emotionally. The expert care at Autumn Leaves can give you peace of mind during your loved one’s early stages of dementia in assisted living, and for mid and late stages, our skilled nursing staff is ready to help. Contact us today to learn more about the compassionate care we offer for residents with Alzheimer’s or another form of dementia. 

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