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Speaking, listening and communication

Contact and communication

"I find it difficult to keep track of conversations so I tend to speak to people less. It’s frustrating because I’m a very sociable person and I like to know what’s going on." (Bill)

"When I’m talking to William, I use shorter sentences, say people’s names more and prompt him a little bit. The conversation is sometimes a bit stilted but the main thing is that we can exchange ideas and pass the time of day." (Pam)

Most people with dementia will at some point in time have difficulty communicating. They may, for example, find it difficult to find the right words, to make themselves understood and to understand others. Concentration can also be problematic. In addition, people with dementia may forget what they wanted to say and what other people have said so far. This can be frustrating and for some people embarrassing. It can also lead to confusion, misunderstandings and even feelings of isolation. A natural reaction to such problems is to withdraw from conversation and to avoid contact with people. Unfortunately, this can lead to a further deterioration of existing skills and for all concerned a loss of companionship.

It is therefore important to try to communicate in a relaxed and creative manner without worrying too much about mistakes and possible misunderstandings. People who do not have dementia can aid communication simply by paying attention to a few basic rules (please see below in the box for carers).

Finally, some people with dementia have difficulty using the telephone as they cannot see the person’s face, may feel under pressure to answer immediately and don’t have time to think. To make matters worse, some may also have poor hearing. The telephone can nevertheless be a useful way to maintain regular contact, particularly where people live far apart, but care should be taken not to overburden the person with dementia.

For the person with dementia

  • Make an effort to speak to people.
  • Take your time.
  • Let others help you (but only when needed).
  • Don’t get discouraged.
  • Avoid large group discussions if you find it difficult to follow the conversation.
  • Alternatively, try to form a smaller group if this is possible and appropriate.
  • Arrange to have your hearing and eyesight checked from time to time.
  • If you have difficulty understanding outside callers (e.g. the Gas Board), ask them to contact a designated relative, friend or neighbour.

For the carer

  • Fix eye contact before starting to speak.
  • Speak slowly and clearly whilst maintaining eye contact.
  • Use short sentences and concrete words.
  • Avoid metaphors e.g. say “wait a minute” rather than “hang on”
  • Use names when talking about other people (not he or she).
  • Accompany your words with gestures and touch when appropriate.
  • Don’t forget that facial expressions (yours and those of the person with dementia) speak volumes.
  • Avoid drawing attention to mistakes or correcting them.
  • Limit yourself to one message at a time.
  • If making an arrangement by phone, follow up the call with a written note or email if possible.
  • If you need to repeat something, try saying it in a simpler way.
  • Give the person with dementia plenty of time to think and react.
  • Help them to find the correct word when needed.
  • Try to finish the sentence if the person is having difficulty doing so.
  • On the other hand, don’t interrupt the person with dementia unnecessarily.
  • Listen attentively.
  • Try to find out what the person is really trying to say rather than concentrating on the literal meaning of the words they are using.
  • Be aware that people with dementia sometimes use words incorrectly or inappropriately and may inadvertently offend people.
  • Pay attention to what the person is communicating through their eyes and body language.
  • Avoid treating the person with dementia like a child.
  • If they have a hearing problem, avoid speaking in a high pitched voice as it is more difficult to hear.
  • Try to minimise background noise and other potential disturbances e.g. the television, people talking.



Last Updated: Friday 11 September 2009