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Communication and Alzheimer's

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Alzheimer's disease and other dementias gradually diminish a person's ability to communicate. Communication with a person with Alzheimer's requires patience, understanding and good listening skills. The strategies below can help both you and the person with dementia understand each other better.


Changes in communication

In addition to changes in the brain caused by Alzheimer's, a number of physical conditions and medications can affect a person's ability to communicate. Consult a doctor if you notice major changes.

Changes in the ability to communicate can vary, and are based on the person and where he or she is in the disease process. Problems you can expect to see throughout the progression of the disease include:

  • Difficulty finding the right words.
  • Using familiar words repeatedly.
  • Describing familiar objects rather than calling them by name.
  • Easily losing a train of thought.
  • Difficulty organizing words logically.
  • Reverting to speaking a native language.
  • Speaking less often.
  • Relying on gestures more than speaking.

Communication in the early stage

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In the early stage of Alzheimer’s disease, sometimes referred to as mild Alzheimer’s in a medical context, an individual is still able to participate in meaningful conversation and engage in social activities. However, he or she may repeat stories, feel overwhelmed by excessive stimulation or have difficulty finding the right word. Tips for successful communication:

  • Don’t make assumptions about a person’s ability to communicate because of an Alzheimer’s diagnosis. The disease affects each person differently.
  • Don’t exclude the person with the disease from conversations with others.
  • Speak directly to the person if you want to know how he or she is doing.
  • Take time to listen to how the person is feeling, what he or she is thinking or may need.
  • Give the person time to respond. Don’t interrupt or finish sentences unless he or she asks for help finding a word or finishing a sentence.
  • Talk with the person about what he or she is still comfortable doing and what they may need help with.
  • Explore which method of communication is most comfortable for the person. This could include face-to-face conversations, email or phone calls.
  • It’s OK to laugh. Sometimes humor lightens the mood and makes communication easier.
  • Be honest and frank about your feelings. Don’t pull away; your friendship and support are important to the person.

We Can Help

If you have questions about communicating with a person with dementia:

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Communication in the middle stage

The middle stage of Alzheimer’s, sometimes referred to as moderate Alzheimer’s, is typically the longest and can last for many years. As the disease progresses, the person will have greater difficulty communicating and will require more direct care. Tips for successful communication:

  • Allow time for response so the person can think about what he or she wants to say.
  • Engage the person in one-on-one conversation in a quiet space that has minimal distractions.
  • Be patient and supportive. Offering comfort and reassurance can encourage the person to explain his or her thoughts.
  • Maintain eye contact. It shows you care about what he or she is saying.
  • Avoid criticizing or correcting. Instead, listen and try to find the meaning in what is being said. Repeat what was said to clarify.
  • Avoid arguing. If the person says something you don’t agree with, let it be.
  • Don’t overwhelm the person with lengthy requests. Offer clear, step-by-step instructions for tasks.
  • Speak slowly and clearly.

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  • Ask “yes” or “no” questions. For example, “Would you like some coffee?” rather than “What would you like to drink?”
  • Ask one question at a time.
  • Give visual cues. To help demonstrate the task, point or touch the item you want the individual to use. Or, begin the task for the person.
  • Written notes can be helpful when a spoken word seems confusing.

Communication in the late stage

The late stage of Alzheimer’s disease, sometimes referred to as severe Alzheimer’s, may last from several weeks to several years. As the disease advances, the person with Alzheimer’s may rely on nonverbal communication, such as facial expressions or vocal sounds. Around-the-clock care is usually required in this stage. Tips for successful communication:

  • Treat the person with dignity and respect. Avoid talking down to the person or as if he or she isn’t there.
  • Approach the person from the front and identify yourself.
  • Encourage nonverbal communication. If you don’t understand what is being said, ask the person to point or gesture.
  • Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind words or sounds.
  • Use touch, sights, sounds, smells and tastes as a form of communication with the person.
  • It’s OK if you don’t know what to do or say; your presence and friendship are most important to the person.

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Formed in 1980, the Alzheimer's Association is the world's leading voluntary health organization in Alzheimer's care, support and research.