When Words Fail

Do’s and Don’ts for Communicating with a Person with Dementia  

A common symptom of dementia is the loss of language and an inability to find the words for things. A person will often know what they would like to say, but are unable to communicate it. While many misunderstand this symptom as simply “memory problems”, the disease actually causes the parts of the brain that control language and store our vocabulary to shrink and die.

When a person with brain failure is trying to think of a word they will often do something we refer to as “circumlocution” where they will verbally dance around the word while they try and think of the right word. For example they may want tea and say, “You know, I need the thing that goes in the hot thing that you put in there and then take it out of there later. Do you have one of those?” While this sounds very vague and difficult to understand it is an important part of their communication process. Here are a few do’s and don’ts to use in this specific situation:

DO

Repeat back the words that they are using. This will help them use a different part of their brain to process their words. For example, if the client says, “Do you have one of those things that go?” You would say, “Do I have one of those things that go?”

Direct them to tell you more about it. When the person with dementia is so vague that you are unsure what they need, say to them, “Tell me more about it.” Getting them to continue to talk about it without the need for the word itself will help you better understand their need.

Direct them to show you what you do with it.  Gestures and visuals are extremely valuable tools in communicating with a person with dementia. By simply asking them to show you what you would do with the item, you can invite them to use another form of communication that doesn’t rely on words. Individuals with dementia will retain the meaning of gestures long after the vocabulary centers of the brain have deteriorated. Accompanying directives with a gesture will also increase understanding, such as demonstrating and gesturing when asking someone one to stand up or sit down.    

DON’T

Do not rush or be impatient. The process of communication can feel painfully slowed down. It is important that the caregiver enter the schedule and pace of the individual with dementia and remain patient with them as they go through the process of communicating.

Do not ignore attempts to communicate. Many people with dementia will speak very little or will prematurely stop communicating because they find it so difficult. When there is a willing, patient, and attentive listener it encourages them to continue to use as much of the brain as they have left and interact and connect with those around them.  

Do not interrupt their speaking with guesses. We often multitask between listening, processing information, and communicating. A person with dementia will eventually lose their ability to hold onto what they were thinking while they listen to you speak. It is only natural to try and guess what the person is trying to say; however when a person with dementia is speaking, listen and repeat back their words rather than guessing 20 different words that they may be looking for.    

Published on February 14, 2014.