Alzheimer’s disease and other forms of dementia “can affect people’s ability to speak or the ability to understand what others are saying or communicate what their needs may be,” says James M. Noble, MD, FAAN, associate professor of neurology at Columbia University Irving Medical Center in New York.

Here are suggestions for improving communication with loved ones who may struggle to find words or follow a train of thought.

Ask them for input. Discussing what kind of assistance they do—and don’t—want can be empowering for people with dementia, says Beth Kallmyer, MSW, vice president of care and support for the Alzheimer’s Association. In early stages, she encourages caregivers to broach the subject by saying something like “When I notice you having trouble communicating, how do you want me to handle it? Do you want me to make suggestions, or is that frustrating to you?” The response may depend on the setting: People may not mind assistance at home, but in public it might make them feel uncomfortable. Set up a help signal, a subtle gesture to show that it’s okay for a caregiver to jump in, suggests Sarah Getz, PhD, instructor of neuropsychology at the University of Miami’s Miller School of Medicine in Florida.

Meet them where they are. As their disease progresses, people may find it harder to communicate and become more frustrated, Kallmyer says. “In those situations, it’s important to speak slowly and ask simple yes or no questions.” Patience and the ability to adapt to changes are key for caregivers, says Dr. Noble, author of Navigating Life with Dementia, part of the Brain & Life Books series. Trying to make loved ones say a word faster or telling them they know the word can just make them feel bad, he adds. Refrain from arguing with, criticizing, or correcting, advises Kallmyer. Instead, listen and try to find a meaning behind what they say, she says. If they confuse you with one of their parents, for instance, talk to them about where they grew up and what they did with that person. That could turn a potentially stressful situation into a meaningful conversation, Kallmyer says. And remember that not all communication is verbal. Sometimes the person’s behavior can provide clues.

Get creative. To enhance a loved one’s memory, incorporate pictures, gestures, calendars, and notice boards, suggests Dr. Getz. And when asking for information, give cues and context rather than using vague questions. For example, ask, ‘Did you have breakfast this morning?’ instead of, ‘Have you eaten?’

Establish routines. Maintaining the same schedule and keeping items in their places can be very helpful, says Dr. Getz. It also may allow the person to remain independent for longer.

Don’t take it personally. Try not to let behaviors like repetitive questions bother you, Kallmyer says. “Separate the person from the disease,” says Dr. Noble. “The person isn’t behaving this way on purpose,” he says. “It’s part of the disease and well beyond their control.” Realizing that may lessen the caregiver’s and the patient’s distress, he says. “By sharing strategies, doctors are trying to break the cycle of anxiety and distress that happens when caring for someone with dementia.”

Lean on others. The demands of caregiving can affect physical and mental health, says Dr. Noble, who has heard caregivers say that the silence that results from losing communication with someone they love can make life lonely. “That lack of interaction can be upsetting,” he says. Caregivers may benefit from talking with a therapist or calling the Alzheimer’s Association helpline, which is staffed by social workers and counselors, says Dr. Getz. The association’s website has an online community where caregivers can find ideas and support. “Sometimes it’s important for caregivers to talk to others who are going through the same thing,” Kallmyer says.

Learn More

Listen to our podcast interview with Beth Kallmyer, MSW, who talks about how the Alzheimer’s Association supports caregivers of those with dementia. Copies of Navigating Life with Dementia are available through most major booksellers.