10 Helpful Dementia Communication Strategies

Caring for a relative with memory changes can be rewarding as well as frustrating and exhausting.  Regardless of the underlying etiology of the memory loss, the principles of caring for the individual are the same.

Changes in your communication style can increase understanding and decrease frustration and angry outbursts.

Here are some recommendations studies have found to be helpful in dealing with dementia:

1. Never argue with someone with dementia – no one wins the argument.
2. Validate feelings expressed by the individual with statements such as:
   1. “I understand how you feel.”
   2. “That must be frustrating for you.”
   3. “Tell me more about it.”
   4. “What can I do to help?”
3. Recognize that long-term memory may be intact but current memories are quickly forgotten. The person with dementia may ask the same question repeatedly.  Be patient and answer the question as many times as needed.
4. Give cues to help orient the individual. Statements that provide detailed information can help with event recognition.  For example, announce that “It is twelve o’clock; it is time for lunch.”  The person may be hungry but not know that it is the middle of the day.
5. Do not ask questions that test the memory such as “Do you know what day it is?” or “Do you remember me?” Instead say “Hi Mom, I am Mary, your favorite daughter! I told you I would come to visit you on Tuesday. Today is Tuesday, and here I am.”  This communication approach preserves their dignity and orients them.
6. Make labels and signs to help with independence. For example, label kitchen cabinet doors with note cards that read “cereal,” “cookies,” etc.  Use signs to serve as reminders.  For example, “Lock the door,” “put your phone in your pocket,” or “turn off the lights.”  Signs can also be used to provide simple step-by-step directions, such as how to make tea: “Fill a cup with water, put a tea bag in the cup, place the cup in the microwave, and press the 1 button.”
7. Use a medication box instead of relying on the person to open bottles of pills. If appropriate, program the person’s cellphone with an alarm to signal time to take medications or call on the phone to provide med reminders.  Note:  Monitor that the medications are being taken correctly (i.e., as dosed, not all at once).
8. Use simple directions. Telling the person to get dressed may be overwhelming, and they may not know how to start.  A better way is to direct the process and say, “Put on your shirt…Now put on your pants…Here are your socks…”
9. Redirect escalating behavior. For example, when the person makes statements like, “I want to go home…this is not my home…I am being held against my will,” a possible redirect could be “That must be frustrating, let’s go see if it is still raining.”
10. Turn comments that are out of context into conversations. If the person keeps asking “Where is Harry…I can’t find Harry” do not respond, “Harry died 15 years ago.”  Instead say, “Tell me about Harry. How did you meet?”