2.4 Use different communication techniques with an individual who has dementia

This guide will help you answer 2.4 Use different communication techniques with an individual who has dementia.

Supporting a person who has dementia often means adjusting how you communicate. Dementia can affect memory, thinking, language skills, attention, and the ability to interpret what is happening around them. This can make communication harder, for both the person and their carers or support workers. Good communication techniques can reduce stress, improve relationships, and help the person feel valued and understood.

When working with someone who has dementia, patience and flexibility are very important. You need to adapt your approach according to their needs at that moment. This can mean using a mix of verbal, non-verbal, visual, and physical communication methods.

In this guide, we focus on how to use different communication techniques in practical, real-life care settings.

Impact of Dementia on Communication

Dementia affects the brain, which can lead to problems with:

• Finding the right words or remembering names for objects and people
• Understanding the meaning of words
• Losing track of conversations
• Repeating statements or questions
• Mixing up words or using sentences that do not fully make sense
• Changes in tone, pitch, and volume of speech
• Reading and writing difficulties
• Recognising familiar voices or faces
• Processing information slowly

These changes can cause frustration. The person may withdraw from conversations, appear upset, or respond with agitation. Recognising that these are symptoms of the condition, not a deliberate choice, can help you respond calmly.

Verbal Communication Techniques

Speak Clearly and Slowly

Use short, simple sentences. Speak at a pace that gives the person time to process what you are saying. This avoids overwhelming them with too much information at once.

Use a Warm Tone of Voice

The tone of your voice can communicate reassurance and empathy. Avoid speaking in a loud or sharp tone unless there is a safety concern.

Avoid Complex Language

Do not use jargon or long, complicated words. Keep your message straightforward. Use familiar terms that the person is more likely to recognise.

Repeat or Rephrase if Needed

If the person does not understand, try saying it in a different way rather than repeating it at the same speed or tone.

Ask One Question at a Time

Multiple questions at once can be confusing. Give them time to answer before asking another.

Non-Verbal Communication Techniques

Sometimes words alone are not enough. Non-verbal communication can give extra meaning or reassurance.

Maintain Eye Contact

Gentle eye contact can help the person focus on you and feel connected. Avoid staring, which might feel intimidating.

Use Appropriate Facial Expressions

Smiling or showing a calm expression can help make the person feel safe and relaxed.

Use Gestures

Pointing, demonstrating, or using hand movements can help explain what you mean. Be consistent so they associate the gesture with the meaning.

Respect Personal Space

Approach the person from the front, not from behind. Moving too close too quickly can cause them to feel startled.

Visual Communication Techniques

Visual cues help support both verbal and non-verbal messages.

• Use pictures to represent common tasks, such as eating or going to the toilet
• Show objects when talking about them, for example, holding a cup when asking if they want a drink
• Label cupboards or doors with text and images to help orientation
• Use written notes for reminders if the person can still read

Physical Communication Techniques

Physical touch can be powerful when used appropriately.

• A gentle touch on the hand or arm can offer comfort
• Holding hands during conversation can help the person feel grounded
• Offering your arm to guide them can help with movement and stability
• Avoid sudden or firm grips that might cause alarm

Always be aware of the person’s preferences and cultural background before using touch.

Adapting to the Individual

Every person with dementia will have their own abilities, preferences, and responses. One technique may work one day but not the next. Observing and listening to their reactions will guide you on which approach is best.

• Try different methods to see which gets the best response
• Be prepared to change your approach during the same interaction
• Respect their pace and do not rush them

Reducing Distractions

A noisy or busy environment can make communication much harder.

• Choose a quiet place for conversations
• Turn off background noise such as televisions or radios
• Reduce the number of people talking at the same time
• Sit at the same level as the person so they can focus on you

Using Validation Techniques

Validation means accepting and acknowledging the person’s feelings and perspective, even if their facts are wrong.

For example, if a person says they need to go to work, instead of correcting them bluntly, you might respond with “You really liked your job, didn’t you?” This approach focuses on their emotion and avoids unnecessary distress.

Using Reminiscence

Reminiscence is encouraging the person to talk about the past. Long-term memory is often stronger than short-term memory in people with dementia.

Techniques include:

• Showing photographs of family, old workplaces, or familiar places
• Talking about past events, hobbies, or music they liked
• Allowing them to lead the conversation

This can build confidence and positive emotions.

Supporting Choice and Control

Even when communication is affected, the person should feel involved in decisions.

• Offer choices visually and verbally, for example, “Do you want tea or coffee?” while showing the cups
• Keep choices simple to avoid confusion
• Give time for them to respond instead of moving on too quickly

Using Assistive Technology

Some people with dementia can benefit from devices that support communication.

Examples include:

• Picture boards or cards
• Audio prompts or recorded messages
• Digital screens showing the day, date, and time
• Applications designed for aiding memory and conversation

Any technology should match the person’s comfort level and abilities.

Communicating During Difficult Moments

Dementia can sometimes cause behaviour that seems challenging. This may include shouting, pacing, or refusing care. These behaviours can be linked to difficulties expressing needs.

During these moments:

• Speak in a calm voice
• Keep your own body language open and non-threatening
• Avoid arguing or getting drawn into confrontation
• Focus on reassurance first and problem-solving second
• Step back if the person needs space, then try again later

Working with Families and Other Professionals

Families can give insight into the person’s preferred communication style, likes, and dislikes. Colleagues and other professionals can share effective techniques that have worked in the past. Good teamwork ensures a consistent approach, which can make communication clearer for the person.

• Keep families updated on changes you notice
• Share strategies with your team
• Record communication preferences in care plans

Recording and Reviewing Communication Approaches

Documenting what works and what does not helps others provide better support. Notes could cover:

• Words or topics that spark a positive reaction
• Situations that cause distress or confusion
• Preferred languages or dialects
• Effective gestures or prompts

Review these strategies as dementia progresses, because needs may change.

Building Trust Through Communication

Trust grows when the person feels listened to, respected, and safe. The way you communicate can make a big difference in whether they feel supported or anxious.

To build trust:

• Keep your promises
• Follow a regular routine when possible
• Be consistent with your communication style
• Show patience and avoid expressing frustration

Trust makes it easier to encourage participation in daily activities and personal care.

Practical Example

Mary is an 82-year-old woman with dementia living in a residential care home. Staff noticed she often became confused at mealtimes and refused food. The team decided to try different communication techniques:

• They sat at her eye level before speaking
• They used pictures of the food available
• They spoke slowly, using simple sentences
• They allowed her to touch or smell the food before deciding
• They used her daughter’s advice to call her by her nickname, which she recognised more easily

After a few days, Mary began responding with more smiles and accepted meals more often. This shows how adapting communication can improve quality of life.

Final Thoughts

Supporting someone with dementia is about recognising that communication is more than words. It is a mix of what you say, how you say it, and how you use your body, face, and environment to make your message clear and comforting. By blending verbal, non-verbal, visual, and physical techniques, you adapt to the person’s needs and abilities in that moment.

The key is patience, observation, and flexibility. What works today may not work tomorrow, so being willing to try different approaches is important. When you take time to listen, respond with empathy, and respect the person’s dignity, you create a foundation for better understanding, connection, and care.