Dementia communication: Try these proven techniques for calm and effective communication

Did you know that just 7% of communication is the words we use? The rest is body language and tone of voice. Even if a person with dementia cannot follow what you’re saying, they can still pick up on these non-verbal cues – and that is why calm, conscious communication is so important when you are caring for or spending time with someone who has dementia. 

These techniques will help you to communicate in ways that will have a positive effect on how you interact with people with dementia.

The rewards are well worth the effort too, as good communication is an important part of maintaining your bond with a person living with dementia and upholding their quality of life. 

How to adapt your communication style 

It can take time to adjust the way you communicate, especially when you’re with a loved one who you have known for many years, or even your whole life. 

When caring for someone with dementia, being patient, calm and clear is important for two main reasons: 

  • Progressive memory loss impacts their ability to organise and express their thoughts
  • Recent memory loss causes the past to merge with the present, which creates confusion

The way you communicate can help to alleviate the feelings of stress and frustration that a person with dementia experiences in these situations. 

As more research is being conducted into dementia, effective communication techniques are being validated. But before we dive into those, let’s first look at the general dos and don’ts of communicating to someone with dementia. 

What not to do when communicating to someone with dementia 

  • Speak over loud background noise such as TV or radio.
  • Communicate when you are out of their eyesight.
  • Ask multiple questions after each other.
  • Use negative body language or a condescending tone of voice.
  • Argue or raise your voice.
  • Talk about the person as though they aren’t there.

What you should do when communicating to someone with dementia 

  • Remain calm and speak in a gentle, matter of fact way.
  • Use a respectful tone of voice.
  • Try to maintain eye contact.
  • Focus on one idea or question at a time.
  • When asking questions, phrase them for simple yes or no responses (e.g. ‘Would you like roast chicken for dinner?’ instead of ‘What would you like for dinner?’).
  • Allow plenty of time for the person to process what you have said.
  • Try to put places and people into context (e.g. ‘your daughter Kate’ or ‘your hometown Cairns’).
  • Use body language, hand gestures and facial expressions to explain something. 
  • Demonstrate activities you would like the person to engage in.
  • Emphasise what the person can do, rather than what they can’t. 
  • Use gentle touch on the person’s hand or shoulder, if appropriate. 

Irregular routines and inconsistent communication styles among family and carers can also create confusion, so aim for as much consistency as possible. Dementia Australia has more insights on maintaining positive communication, including a helpful series of tips provided by a woman living with dementia. 

Also remember that it’s much harder to maintain positive, calm communication if you aren’t taking care of yourself. As a carer, friend or family member, your own self-care is important too

Three communication techniques to try 

Now that you have an overarching understanding of the general rules of communication, here are three techniques you can try. You may already be doing some of these things intuitively and, if so, well done. 

When trying these techniques, the general communication tips above still apply.

1. Reality Orientation

Suitable for: Alleviating disorientation and confusion

This technique works best in the early stages of dementia, when the concept of time and date is still comprehensible. It works by using a tool like a reality board (explained below) to bring a disorientated or confused person back to their present reality. 

Reality Orientation in practice

A reality board is a great tool for Reality Orientation. Each day, write important information on a whiteboard or noticeboard, such as the date, day of the week, weather and upcoming activities for the day or week, such as visitors and appointments. When the person with dementia becomes disorientated or confused, use the reality board to re-orientate them to the present by gently bringing awareness to who they are, where they are, and the present time and/or date.

2. Validation Therapy

Suitable for: Building trust and a sense of security

Feeling confused is an overwhelming situation for a person with dementia, and it can be difficult to know how you can be of help when this happens. Validation Therapy is best used for someone who has substantial short-term memory loss and can no longer understand the present. 

In this situation, a person with dementia goes in and out of the past and present, and it can feel wrong to allow them to ‘live’ in the past. However, when you enter into their perceived reality, you reduce conflict and this builds trust and security. You do this by acknowledging the person’s view of reality, listening and asking questions.

Validation Therapy in practice 

People with dementia will often return to the past and do not always have the cognitive ability to come back to the present. For example, they may think they’re waiting for a spouse to return home from a job they held many decades ago. When this happens, simply acknowledge their thoughts about what they perceive to be happening. This approach avoids perpetuating any feelings of frustration and low self-esteem. 

3. Reminiscence Therapy

Suitable for: Reducing stress and building strong emotional bonds

At every stage of dementia, positive experiences are an important part of maintaining quality of life. Reviewing the past is enjoyable for most people with dementia and is a beneficial communication therapy, as it gives them a feeling of value, belonging and peace.

Participating in this activity also builds deeper relationships, but remember to be gentle and light (something that is more difficult when you have been heavily invested in that person’s life).

Reminiscence Therapy in practice

There are many ways to apply ReminiscenceTheory and your approach should be tailored to the individual life experiences and interests of the person you are caring for. Each tactic should be performed individually to avoid confusion. 

Common tactics include: 

  • Looking through family photo albums.
  • Creating a scrapbook organised into different periods of life, such as childhood, marriage, family, holidays and career.
  • Discussing a favourite item of clothing, or the history of a sentimental ornament or trinket.
  • Listening to familiar songs and singing along or discussing the memories they trigger.
  • Planning activities the person previously enjoyed, such as painting or gardening.

It’s important for everyone to understand how to communicate with someone who has dementia, with initiatives like dementia-friendly communities showing the benefits of a community-wide approach. 

For more practical information on caring for someone with dementia, see our free Dementia Care Guide, which has been created specifically for carers and families. It includes tips for managing behavioural changes, planning activities and accessing services that can assist you. Or if you require in-home assistance caring for someone with dementia in Melbourne's Eastern Suburbs, see our approach to dementia care.