Communication Tips

DoDon't
Talk to the person in a tone of voice that conveys respect and dignity Talk to the person in 'baby talk' or as if you are talking to a child
Keep your explanations short. Use clear and flexible language Use complicated words or phrases and long sentences
Maintain eye contact by positioning yourself at the person’s eye level Glare at, or eyeball, the person you are talking to
Look directly at the person and ensure you have their attention before you speak. Always begin by identifying yourself and explain what it is you propose to do Begin a task without explaining who you are or what you are about to do. Talk to the person without eye contact, such as while rummaging in a drawer to select clothing
Use visual cues whenever possible Try to compete with a distracting environment
Be realistic in expectations Provoke a catastrophic reaction through unrealistic expectations or by asking the person to do more than one task at a time
Observe and attempt to interpret the person’s non-verbal communication Disregard your own non-verbal communication
Paraphrase and use a calm reassuring tone of voice Disregard talk that may seem to be rambling
Speak slowly and say individual words clearly. Use strategies to reduce the effect of hearing impairment Do not shout or talk too fast
Encourage talk about things they are familiar with Interrupt unless it cannot be helped
Use touch if appropriate Attempt to touch or invade their personal space if they are showing signs of fear or aggression
Ideas for communicating with a person with dementia
  • Communication occurs in a quiet place that is free from distraction
  • The person’s language and culture are taken into account and not disregarded
  • Communication does not overestimate the person’s perception, attention span, intellectual understanding or memory
  • Communication is open and conveys respect and trust. Patronising speech or talking to the person with dementia in a childlike way may either foster a sense of helplessness and dependency or trigger an angry and defensive response
  • Each person has an opportunity to respond
  • Sensory aids (hearing aids, spectacles) are appropriately utilised and sensory impairments (wax, cataracts) are treated.

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Make sure that you can be seen and heard:
  • make sure the hearing aid is on (if applicable)
  • stand in front of the person where they can see you
  • face the person directly so they can see your facial expression and mouth
  • place yourself at eye level when talking or listening
  • identify yourself by name
  • use the person’s name

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Make contact with the person:
  • try to keep calm and relaxed
  • touch gently if the person likes to be touched
  • smile and use humour

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Make the communication simple and easy to understand:
  • use gestures, pictures and/or signs to explain or express things
  • avoid talking over/across/about the person with dementia
  • speak gently and clearly at an even pace - avoid shouting
  • ask one question at a time
  • use names of people and places instead of pronouns: eg; Jack, our neighbour, or Muffy, our dog.
  • use a statement rather than a question
  • wait for a response before continuing
  • explain what you are going to do & what you are doing
  • repeat or rephrase your message if there is no response.

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Other suggestions:
  • talk normally: they will understand how you are feeling, even if they are not aware of what you say
  • use hand gestures and facial expressions such as smiles to reinforce your words
  • allow for the time a damaged brain takes to process messages
  • show your concern with reassurance and acceptance
  • give praise when it’s appropriate
  • respond to the feelings expressed by the person
  • when talking in a group, place the person so that the conversation is around them and they won’t feel ‘left out’
  • make it easy to join in conversation by asking questions that only need a ‘yes’ or ‘no’ answer
  • arguments over mistaken ideas should be avoided: eg; If the person insists they have seen a TV program a million times before even though it is a first run say: “Oh well, I don’t think I’ve seen it before. It’s interesting isn’t it?”
  • touching enhances feeling of security: especially if the person is upset.

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References and recommended reading

Alzheimer's Association Australia (2000).  Help Sheets for people with dementia and their families and carers. Alzheimer's Association Australia. www.alzheimers.org.au/.

Department of Veterans Affairs - Health Promotion Section & Alzheimer's Association Australia (2001).  Living with Dementia - A guide for Veterans and their Families. Commonwealth of Australia www.dva.gov.au.

Keane, B. & Dixon, C. (1999).  Caring for people with problem behaviours. 2nd Ed. Ausmed Publications, Australia.

La Tourette, T.R. & Meeks, S. Perceptions of patronizing speech by older women in nursing homes and in the community: Impact of cognitive ability and place of residence. Journal of Language and Social Psychology; Vol.19:No.4.pp.463-473

Robinson, A. Spencer, B. & White, L. (1991) Understanding Difficult Behaviours: Some practical suggestions for coping with Alzheimer's Disease and related illnesses. Eastern Michigan University, USA

Santo Pietro, M.J. & Ostuni, E. (1997) Successful communication with Alzheimer’s Disease Patients – An In-service Manual. Butterworth-Heinemann, www.bh.com/med

Teri, L. (1999) 1] Latest advances in the assessment and management of behavioural symptoms: an international perspective: 2] State of the art strategies in approaching behavioural disturbance and depression in dementia. Papers presented at Symposium reporting the latest evidence-based practices in the care of behavioural symptoms of dementia, Melbourne.