How to Talk to Someone With Dementia
Keep questions simple, try not to correct, and listen for the feeling behind the words. That’s the heart of the Alzheimer’s Association’s advice.
When communicating with a person living with dementia, the Alzheimer's Association advises avoiding criticism and correction, and listening instead for the meaning in what the person says.
The hardest habit to let go of is correcting.
When someone you love says something that isn’t so, it’s natural to put it right. The Alzheimer's Association’s guidance goes the other way: avoid criticizing or correcting, listen, and try to find the meaning in what the person says.
A question about someone from long ago is rarely a question about a fact. It’s more often a wish for reassurance, a worry, or a need that hasn’t been put into words yet. Answering the need tends to help more than getting the facts straight.
Letting go of correcting is the highest yield change most families can make, because it costs nothing, it works in every room of the house, and it needs no training to begin. It’s also one of the hardest, because correcting feels like helping while you’re doing it. Be patient with yourself as you practice.
Care professionals here are trained on disease states and on health and wellness. Our caregivers take part in dementia training, and our nurses hold the Certified Dementia Educator certification. That’s why the first thing families tend to notice is what a caregiver doesn’t do: no arguing about the day of the week, and no quizzing about who just visited.
When something they say isn’t so, what might it be about?
It's a worry about someone
Answer the worry rather than the facts. Offer reassurance, then gently move the conversation on.
dementia care at homeConversations get harder late in the day
If the same conversation tends to get harder at the same time each afternoon, the time of day is worth looking at too.
what to do when sundowning startsThe afternoon needs something to do
A repeated question can be a sign the day needs more in it. Something to do with the hands often helps.
activities for dementia patients at home
Ask questions that one word can answer
Yes or no.In the middle stage of Alzheimer's, the Alzheimer's Association advises asking yes or no questions, such as would you like some coffee, instead of open ended ones. An open question asks a person to search for words, hold the question in mind and put an answer together. A yes or no question offers one of two answers that are already there.
Guidance written for Alzheimer's applies in many families, because Alzheimer's disease is the most common cause of dementia and accounts for 60 to 80 percent of cases. Source: Alzheimer's Association, the difference between dementia and Alzheimer's.
Here are a few examples.
Would you like some coffee?
One word answers it. What would you like to drink asks them to search for a word.
Tea, or coffee?
Two options work the same way. Hold both up where they can be seen, if you can.
Are you cold?
Easy to answer. How are you feeling asks for a lot more.
Shall we sit by the window?
A simple invitation, with somewhere to go next.
None of this is a script. Simple questions just make the conversation easier, so there’s more room for what your mother or father wants to say.
Later on, feelings matter more than words
Communication changes over time. For a long stretch, words still carry most of the conversation and simple yes or no questions are most of what’s needed. Later, words may come less easily, and the same careful question may not work the way it did.
In the late stage, the emotions being expressed can matter more than the words, so caregivers are advised to consider the feelings behind words or sounds. Even when a sentence doesn’t quite make sense, it can still tell you whether someone is comfortable, worried or ready for a change of scene.
In practice, that means listening for tone more than content, and answering what you hear underneath. A warm voice, unhurried company and a gentle touch where it’s welcome mean a great deal, and quiet time together is good time too.
This advice comes from the Alzheimer’s Association. Alzheimer's Association, communication and daily care.
Respond to the feeling, not to the vocabulary.
- Middle stage
- Yes or no questions. Two visible options. One word gets you an answer.
- Late stage
- The feeling behind the words or sounds. Tone, presence, and time.
- Both stages
- No correcting. Listen for the meaning in what the person says.
How our caregivers talk with your parent
A caregiver arrives and skips the test: no do you remember me, just would you like some coffee. Through the day the questions stay easy to answer, and things that aren’t quite so aren’t argued with. A worry gets reassurance, and a story from long ago gets listened to.
Later in the day, a caregiver may ask fewer questions, use shorter sentences and pay more attention to the feeling behind the words. The training behind that covers disease states and health and wellness, and it is the reason the same hour can go two very different ways depending on who is in the house. Our caregivers take part in dementia training, and we choose the caregiver with your parent in mind and introduce them before the first visit.
If you’d like someone with that patience there on a regular schedule, read about in home dementia care.
Endurance Home Care helps with daily life at home: company, meals, the house, errands, appointments and, where it's needed, hands-on personal care. For skilled nursing, home health aides or physical therapy in Connecticut, our separate company, Endurance Home Health, can help.
Questions families ask
How to talk to someone with dementia
Try not to correct. The Alzheimer's Association advises avoiding criticism and correction, and instead listening to find the meaning in what the person says. In the middle stage, ask yes or no questions such as would you like some coffee rather than open-ended ones. In late stages the emotions being expressed can matter more than the words, so respond to the feeling behind the words or sounds.
What if they say something that is not true?
Correcting rarely helps and can make the moment harder. The guidance is to avoid criticizing or correcting, and to listen for the meaning underneath: a wish for reassurance, a worry about someone, a need that hasn't been put into words yet. Answering that need often helps more than getting the facts straight.
How should questions be phrased?
In the middle stage of Alzheimer's, ask yes or no questions, such as would you like some coffee, instead of open-ended ones that require assembling an answer. Offering a choice between two visible options works on the same principle.
What changes in the late stage?
The emotions being expressed can become more important than the words, so caregivers are advised to consider the feelings behind words or sounds. Tone, touch where welcome, and unhurried presence carry more than vocabulary at that point.
Let’s talk about what would help your family
Tell us about your mother or father and the conversations that have become harder. We’ll talk through how a caregiver could help. Daily-living companion and home care across Connecticut, New Jersey and New York, from an agency registered with the state. The first conversation is free, and nothing starts until you say so.