
Kathleen Allen, LCSW, C-ASWCM
Kathleen Allen has been working with older adults and their families for over 20 years.
Senior Care Management Services, LLC
Learn helpful communication tips for visiting someone with dementia, or communicating with them by phone or video chat.
Have you ever tried to communicate with someone with Alzheimer’s disease and ended feeling awkward and frustrated? Did you get stuck without having anything to talk about? Was this a once conversant and articulate person you now have difficulty engaging?
Communicating with someone who has Alzheimer’s disease, though challenging, is achievable. But because the disease affects the brain in ways that make communication difficult, we need to keep in mind some guidelines to facilitate the best possible communication. Below I will address communication when you are visiting someone with dementia, and then I will address non-visit communication, such as by phone or video chat.
Christi Clark and Carrie Idol-Richards of the Insight Memory Care Center in Fairfax, Virginia refer to the “Basic 6” steps for communicating with someone with dementia. The steps they describe provide an excellent framework to use on your visits as you approach and converse with someone with Alzheimer’s or other dementia, and are especially relevant during the middle stages of the disease.
Approach from the front – do not startle them.
Establish eye contact – this shows interest in them.
Call the person by name – again, showing interest in them.
Get down to eye level if needed – this puts you on the same level with them.
Let them initiate touch – they will come to you when ready.
Give directions one step at a time – this helps keep it simple, especially for those having difficulty with processing.
One thing is certain—visits will go better if you are prepared with a plan. Be prepared by visiting at a good time of day for your loved one, and keep your stay short. Go with some ideas for conversation, but be prepared to follow their lead if they are especially talkative that day. Have a plan for an activity. Here are some specific ideas to help a visit go well:
Reminisce: If your loved one is particularly talkative that day, pay attention to what they say and meet them where they are. If they are talking about a time they went to the beach, then talk about the beach. In that moment, they are thinking of the beach, and that is where they need you to be as well. Or, perhaps they are talking about a family member. Follow their lead and contribute to the conversation with your own memory or question. It may not trigger a thought from them, but it might. It is okay if it does not. Just keep in touch with their thoughts and let them show you where they are. If you have photos to share, they can also aid in reminiscing. Note: if they sometimes express something that is not true, it is best not to correct or argue with them about it. For them, maybe their mother was there this morning, even though you know she passed away twenty-five years ago. They are only able to see their reality and it is best in these moments to leave the inaccuracy alone, and just accept it as it is.
Activity: ideally, include some activity in your visit. Activities such as a walk, a trip to the local park, or a gardening activity are some ideas. If there is something you know they enjoy doing, join them in that activity. Make it something you know they enjoy.
Talking on the phone can be so difficult. Many of us realize this when we call someone with Alzheimer’s. The calls we once made and were easy can become so quiet and one sided. While there is no magic to having a fruitful call with someone with Alzheimer’s, there are ways to enhance the dialogue. And again, it starts with a plan.
Call at the time of day you know to be best for them. As a backup, be prepared with topics. Listen well to what they say and join them in their topic. Remember, sometimes conversations, whether via phone or in person, might just feel frustrating. If that happens, try again next time. Your skills will likely improve each time.
Kathleen Allen has been working with older adults and their families for over 20 years.
Donate to help end Alzheimer's Disease
Receive Alzheimer's research updates and inspiring stories