How to Talk To Someone Who Has Dementia

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A frequent challenge faced by loved ones is just how do you talk to someone who has Dementia. Communication is often strained or even non-existent as we struggle to connect with a person we barely know anymore.

• Am I going to say the right thing?
• Is our conversation going to cause more anxiety?
• What if they don’t talk back to me?
• Am I going to cause emotional pain or confusion without meaning to?
• Is conversation even worth it anymore?

These are all questions that enter our minds when we try to talk to someone with Dementia. Instead of feeling positive and hopeful about a visit or encounter we feel strained and anxious.

What you say still matters

I was changing my MIL’s bedsheets. She asked me if there was anything she could do to help. In a hurry and a bit perturbed to be having to do this chore yet again, I replied, “No, it’s easier and quicker if I just do this myself. You aren’t strong enough and can never remember how to do this anyway.” 

I remember my response verbatim because I regretted it immediately after the words came from my mouth. My response to her offer took an already humiliating situation and drove it further into the ground by my thoughtless words.

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One of the hardest parts of caring for and knowing how to talk to someone with Dementia is avoiding further confusion and conflict. We have to learn new ways of communication. So how do we keep confusion and conflict at a minimum when we talk to someone with Dementia? 

Always agree, never argue

When we talk to someone with Dementia it is easy to want to correct them. We hear them mix up memories or even create new ones. The temptation to steer them toward the truth is strong. In their mind however, they are speaking truth. There is rarely any malicious intent behind the lies.

My MIL walked into the kitchen convinced it was the late 1700’s and we were living in Ireland. She had been reading a book and it became real for her.

Instead of trying to convince her it was 2017 and we live in Texas, I pulled out the potatoes we were having for dinner and told her we need to thank God we didn’t have another potato crisis! Soon, she forgot her delusion and life moved on.

When we argue not only does it do nothing to persuade her differently but it causes animosity and backlash. In  dementia, you never know what she will remember the next day. I would hate for her memory to be of an argument. As we talk to someone with Dementia we need to work hard to enter into their world and remember to agree even with their delusions.

Related Post: Answering the Difficult Questions Asked By Your Elderly Parent

Always redirect, never reason

When we talk to someone with Dementia we sometimes unintentionally and despite our best efforts stumble on a subject that causes tension or even argument. In these instances, while we want to reason our way out of the argument or try to convince, our best course of action is redirection.

In our home we have a Keurig coffee maker. We bought one of the refillable pods, in an effort to save money because K-cups are expensive!

One morning, I came into the kitchen to find out my MIL put uncooked rice and various seasonings into the pod. Rather than tell her why this was a mistake, I pulled out the coffee and asked if I could make her a cup. We avoided an argument and both got our much-needed morning coffee faster.

Believe me, I get the urge to reason. I so often think that if I just explain it another way, maybe she’ll understand this time. But, the fact is, a mind with Dementia just doesn’t work that way anymore. Reason is gone so we must find another way. That’s why when we talk to someone with Dementia redirection becomes our best strategy.

Always distract, never shame

A common issue when we talk to someone with Dementia is our words and actions can bring shame and humiliation to our loved one.

• Talking about them instead of to them or with them.
• Pointing out the weird or surprising things they do or say.
• Correcting them especially in front of others.
• Making a big deal of accidents and things they can no longer control.

Dementia carries enough humiliation and shame without our help. As difficult as it is, when we talk to someone with Dementia we must remember not to bring further humiliation on our loved one.

My MIL had a huge accident in her bedroom.  She had taken a laxative without my knowledge the night before and it was very effective. I wanted to impress on her the importance of taking her medicines properly, wearing her underwear, paying attention to her body, and so much more! But, if I lectured her I would only bring her further shame and embarrassment.

Instead, I got out fresh clothes and a towel and said there is no better way to start your day than a good, hot shower. I got her seated in her shower with the water going and started cleaning up.

When I was done, I helped her out of the shower and into the kitchen for breakfast. By the time she returned to her room there was no evidence or remembrance of the earlier accident.

This is a confusing time for your loved one. They are aware they are losing parts of themselves. They are aware they can’t do things that came so easily to them before. Why add shame to make them feel even less like the person they were?

Related Post: How to Use Alert Cards to Preserve Your Aging Parents’ Dignity

Always reassure, never lecture

Going hand in hand with not bringing shame when we talk to someone with Dementia is providing reassurance. They need to know you’re there to support them and hold their hand (figuratively and literally) through this very dark disease.

Every few months we go through a period where my MIL no longer feels the need to wear underwear. This means multiple accidents in the bed and around the house.

The first several times this happened, I would lecture her about the necessity of wearing the underwear. I would question her motives, her thinking, anything to impress on her the importance of wearing proper undergarments. I even went so far as to have her daughter who she highly respects, create “reminder signs” that I hung in obvious places around the house.

Eventually, I realized those lectures were falling on deaf ears. Nothing I said was going to change the fact that she just didn’t “automatically” see the need to wear her undies. I took down the signs, stopped lecturing, and just frequently help her into her underwear while reassuring her that incontinence is often just an unfortunate part of aging.

Always reminisce, never say “remember”

One of the first things we do when we sit down to talk to someone with Dementia is try to bring up old memories. We try our hardest to scrape together the remnants this disease leaves behind just to get a glimpse of the person we knew.

It can be so frustrating when your loved one can’t remember to do something that seems so obvious to you. My MIL gets people and places confused. She forgets names. She doesn’t always recognize the home in which she raised her children. Sometimes she’ll see a picture of a famous person (past or present) in a book and create stories around them.

There are so many times when I want to tell her she did not in fact personally hang out with Walt Disney. Nor was she a close friend of Queen Elizabeth II. I want to beg her to remember her own history but that part of her mind is being destroyed by Dementia.

Instead of trying to force her to remember, I recall it for her.

Talk about the good times, the trips, the family and friends. Look through old photos and recollect as you go. Not only have you created a happy moment for your loved one but you’ve added a wonderful memory for you.

Related Post: How to Get to Know Someone Who Can’t Communicate

Always repeat, never say, “I already told you”

One of the most frustrating parts of trying to talk to someone with Dementia is the constant repeating. Questions will be asked over and over again with no memory of it being asked before. Statements will be repeated continuously and sometimes without pause.

It’s so frustrating to have to repeat yourself over and over again as if it’s the first time you’ve heard it. It’s hard to contain your anger when you’ve answered the same question countless times. You struggle to show enthusiasm when they share a victory more times than you can count. You want to run from the room when instead of telling you a story they repeat the same thoughts in a continuous circle.

When you talk to someone with Dementia you have to remember that even though you’ve repeated yourself to the point of frustration, to them it is the first time you’ve responded. When you respond in anger or even mild irritation they have no idea what they could have done and become hurt by your negativity.

Always encourage independence, never say “You can’t”

When you talk to someone with Dementia, they will sometimes express a desire to do something you know will be difficult for them or even impossible. We want to spare them the struggle and do it for them.

Someone with Dementia loses parts of themselves every day. Telling them they can’t do something because it might be difficult for them or because it’s just easier if you do it yourself makes them feel more like a burden.

Never assume they can’t do something. Some days my MIL can’t remember how to pick out an appropriate outfit for the day and other days she is perfectly capable. You never know, so as long as safety is not an issue, always give them the opportunity to do things for themselves.

Always ask, never command

When we talk to someone with Dementia it’s easy to start treating them like children. Many of their thoughts and requests are similar to that of a child. They might even throw a tantrum. It comes naturally to start telling them what to do.

They are still adults and feel humiliated and rebellious when someone starts treating them like a child (even when they’re acting like one).

When we combined our two homes, I carefully created a list of household rules that I expected to be followed. They weren’t hard or unreasonable, just things I thought would help our home run harmoniously and keep our family safe, happy, and healthy.

Not only did I face tremendous resistance from my MIL to these rules but also great resentment toward me. She felt like she was being controlled and reminded me frequently that she wasn’t a child.

I changed my tactics. My questions are highly suggestive, always providing a reason my advice should be taken. “Why don’t you put your glasses in the drawer so the baby doesn’t break them?”

I keep my questions simple, with only one or two options. She feels like she’s still making some decisions without the stress of consequences that might impact the family’s harmony.

There are still times when my MIL needs me to be more authoritative and make decisions for her. Sometimes she will ask for help. Other times she will tell me directly to decide for her. And sometimes I can gauge by her response that my question is causing more confusion and she needs authoritative direction.

Always praise, never condescend

While we rarely intentionally condescend when we talk to someone with Dementia, it’s hard not to do.

• Why did you do that?
• How could you?
• What were you thinking?
• You’re not even trying.

These condescensions and more spring easily to our lips when faced with the irrationality of Dementia.

My MIL recently broke her hip. Her rehab was long and difficult; full of her own resistance and lack of cooperation. There were many times when she would tell us “No!” over and over as we tried to help her move. She would cry out “I can’t” with any request we made, sometimes even as she was following directions.

Many times I wanted to yell back at her and tell her how unreasonable she was being but I knew that would only bring anger and even more resistance.

Instead, I praised her for her efforts. Every try got a “gold star” and our success was excessively celebrated.

Her recovery might not have been any faster, but eventually our efforts were rewarded with her feeling more confident in herself, resisting less and less and cooperating more toward her recovery.

Always reinforce, never force

Finally, when you talk to someone with Dementia you have to remember they are still an adult (even though their behavior is childlike) and you should never try to force them to do anything.

This is perhaps the most difficult strategy of all. As the disease progresses their cooperation becomes almost non-existent.

If you find your loved one resisting a request try making it a statement rather than a question.

When asked if she’s ready or wants to do something, my MIL will immediately say “no”. Usually it’s because she hasn’t had an opportunity to process the request.

Instead, make your requests more of a statement. “It’s time for a shower now,” carries a lot more confidence than “Are you ready for a shower?” “It’s time to go,” is more convicting than “Are you ready to go?”

Your confidence often rubs off on them making them feel more at ease even when faced with a dreaded activity.

Just like my children, my MIL has trouble with urgency. She is rarely in a hurry to do anything, especially when we’re on a tight schedule.

When we have an appointment, I begin getting everyone dressed and out the door at least 2 hours before our time to leave because I know I will be enforcing the same task multiple times.

If you find yourself having to reinforce a request more than a few times, try to discover why you are facing resistance.

• Are they not understanding the request?
• Are they distracted by something else when you are asking?
• Do they just need a break?
• Are they feeling fear or anxiety?

Finding the root of resistance will allow you to develop strategies that address the actual issues rather than find solutions to the symptoms.

Making these rules habit

Whew! This all seems like a lot to remember just to be able to talk to someone with Dementia. It might even seem unrealistic.

No, you’re not going to be able to implement everything on this list every time you talk to your loved one but by keeping them in the back of your mind and practicing one or two of them each time you will soon find your communication much more productive and enjoyable.

Give yourself grace and start each day new. Keeping these things in mind will make living with someone with Dementia so much easier, so much more peaceful. Your relationship will not be full of conflict, there won’t be as much confusion, and you will both be able to focus on the good rather than the negative and live together in harmony.

Did you like this post? What are some tips you have for communicating with your loved one with Dementia? Let me know in the comments below!

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