How to Talk to Someone with Alzheimer’s

Those suffering from dementia or Alzheimer’s experience changes in their brains that affect their ability to listen, understand, and respond to normal conversation. It’s important to meet the person where they are, because once that piece of the person’s brain has stopped working, it will never return to the way it was before. They can no longer process and retrieve information in the same way as they did in the past. Long, complex thoughts seem overwhelming because their brains are no longer able to process that much information at once.

For that reason, the best way to talk to someone with Alzheimer’s is in short, direct sentences, with only one thought per sentence. Since they have less information to process that way, there’s a greater chance that they’ll actually understand what you’re saying and will be able to reply appropriately.

Bear in mind that each individual with Alzheimer’s or dementia will have a different level of cognitive impairment. You can experiment to figure out what approach works best for your older adult in various situations. Be very conscious that you do NOT want to speak to them like a child. Communicate with respect, keeping the person with Alzheimer’s dignity at the forefront. It’s important to use patience, clarity, and positive reinforcement. It can be helpful to make eye contact and use non-verbal cues, such as motions imitating the task you are requesting they complete.

Here are some real-life examples of how you could use fewer words but still communicate kindly:

1. If it’s time for the senior to use the bathroom, simply say, “It’s time to go to the bathroom now.” Don’t say: “Would you like to go to the bathroom now? It’s been about an hour since you last visited the restroom, so how about we go to the bathroom so you can give it a try? Does that sound good?” (Don’t give them a choice or ask their opinion, and there’s no need to explain why.)
2. When it’s time for your older person to have lunch, you can say, “Mmmm, it’s time to eat spaghetti. Let’s go to the kitchen.” Refrain from saying: “Are you hungry? It’s lunch time. I thought you’d enjoy one of your favorites – spaghetti. Let’s go to the kitchen so you can eat. After lunch, we’ll go outside for a walk so you can get some fresh air. How does that sound?” (That is simply way too many ideas and words!)
3. Just before taking your senior to a doctor appointment, tell him or her, “It’s time to go out. [Pause.] Here’s your jacket. [Pause.] Let’s get into the car.” (Use simple statements with brief pauses in between. Don’t even mention you’re going to the doctor.) Don’t get into a lengthy conversation, such as: “We’re going to see your doctor today. She wants to check to see how you’re doing with those new medications. Remember how we had to reschedule your appointment from last month? It’s a little chilly today. Why don’t you put on your jacket while I get the keys? Then we’ll go out to the car together.” (Stay away from a full conversation. Stick to simple statements and commands.)
4. If a family member or friend has come to visit, identify him or her by saying, “It’s Mike, your brother. [Pause.] He wants to say hello.” Don’t say: “Oh look, you have a visitor! Do you know who this is? Mike was just here last week. Do you remember?” (If the individual doesn’t remember, it could be embarrassing or upsetting.)
5. Enter their reality. Go with the flow of the conversation, even if they talk about things that aren’t true or don’t make sense.

The key is to use short sentences with simple ideas. This technique can take some getting used to for the average person because society has taught us to fill silence with words, making small talk and casual conversation. This is often our way of showing someone we care or letting someone know what happened. But with time, this approach will become more natural. Using fewer words with a warm tone will be less frustrating for the senior and will allow you to communicate with them more effectively. if the person you are talking with is struggling to find a word, please be patient and resist the urge to say the word for them.