How does dementia affect communication?

The impact of dementia on communication

Dementia can impact people’s communication in a variety of different ways. This can present in various forms of repetition, forgetting words, becoming confused in everyday interactions, inability to follow a train of thought or plot, offensive or child-like language and overall difficulty in speaking. 

Although it is important to remember that this is more often than not a gradual change, which means that understanding how the condition impacts communication can help you adjust as your loved one’s skills may change, maintaining communication with them is vital to their quality of life and independence. It is really worth being patient and understanding the right approach, even though it might be a challenging part of the journey. 

Other aspects of a dementia diagnosis may also weigh into one’s ability to communicate, such as changes in other senses such as sight and hearing. This can be hard to distinguish but essential to keep track of and adapt to accordingly. 

Why does dementia affect communication?

Most commonly, those with dementia could struggle to successfully communicate as they cannot make sense of their thoughts or are confused about how to articulate themselves. Dementia impacts a person’s ability to apply rationale and can make the clearest of concepts seem incredibly confusing. It is vital to be mindful of that, especially as their struggles will cause them immense frustration. Any negative response to that struggle will exacerbate matters, knocking their confidence, which creates an environment in which it is even harder for them to communicate clearly. 

In technical terms, the condition affects the part of the brain’s left temporal lobe where vital words such as nouns are stored when initially learnt in adolescence. Other formal aspects of language are likely to become compromised over time, and the challenge that verbal communication involves could be too much for your loved one to manage. One typical response is for someone with dementia to become less vocal, remaining quiet for longer periods. The unaffected side of the brain will likely enable your loved one to take part in more basic communicative practices, such as simple conversation and rhythm. 

What can you do to help someone with dementia communicate?

• Start conversations 
• Use short and slow sentences 
• Give them time to speak, encouraging them subtly 
• Clearly show acknowledgement of what they have said 
• Keep offerings and options to a minimum and as simple as can be 
• Happily and calmly rephrase your sentence if needed 
• Ensure to speak with a friendly and warm tone 

What can you do without words? 

• Maintain gentle eye contact
• Stay calm and with calm facial expressions 
• Do not stand over them or in a position that could be threatening 
• Keep a natural amount of distance if appropriate 
• Read their body language 
• Avoid interrupting them at any time 
• Try not to multitask or allow other distractions whilst in conversation

What extra habits can you introduce? 

• Reassure by discussing things that you know your loved one enjoys and knows about
• Accompany your words with a mime, such as miming a sip when offering a cup of tea 
• Routinely check in on if your approach is up to date with their diagnosis 
• Take a moment to yourself when their communication affects you negatively 
• Do not attempt to enter a conversation with them when they can’t see you 
• Stick to one topic of discussion at a time

Overall, the changes that a dementia diagnosis can have on one’s communication skills might feel daunting. Still, this transition is manageable with subtle adjustments and an eye on any developments in their communicative efforts. 

We asked Lifted, one of the UK’s specialist dementia care companies based in London for their experiences while writing this article. They commented, “remember to note other contributing details to what they are trying to say, such as their movement, and persevere until you understand the meaning of what they are saying. Start this observation from a place of knowing your loved one as well as you do. Lifted Carers are trained and experienced in reading these signals, and it is essential to have the same familiarity as a family member.”