Alzheimer’s impacts a person’s ability to communicate in a variety of ways. They may have trouble remembering familiar words, struggle to follow complex trains of thought, and become forgetful about people and events. That means everyday interaction can be a frustrating experience for a person with Alzheimer’s — but some patience and understanding will help you and your loved one understand one another more clearly.
To converse with a person who has Alzheimer’s, you’ll need to adjust your speaking style to make it easier for them to follow the discussion. It’s best to avoid statements and questions that could confuse or upset the person — and use your body language and tone of voice to convey respect, comfort and love. With a little practice, you’ll soon get a feel for how to adjust your communication style to suit your loved one’s unique needs and abilities.
Here are nine handy tips for avoiding common conversational pitfalls, so you can communicate more effectively with the person you’re caring for:
1. Minimize background distractions.
2. Speak to the person respectfully.
3. Speak in short, distinct sentences.
4. Ask questions that are simple to answer.
5. Avoid asking, “Do you remember…?”
6. Don’t correct, contradict or criticize.
7. Listen patiently without interrupting.
8. If the person gets upset, switch topics.
9. Pay attention to non-verbal cues.
Minimize background distractions
Alzheimer’s affects more than just memory. The disease also makes it difficult for a person to tune out distractions, especially during a conversation. To help your loved one avoid losing their train of thought, you’ll want to limit distractions in the environment: turn off radios and TVs, and close any videos or audio apps on electronic devices. If it’s noisy outside, consider closing doors and windows, too. Then position yourself at the person’s eye level, make eye contact, and introduce yourself — or gently remind them of your name and relationship.
Speak to the person respectfully
Although a person with Alzheimer’s can sometimes seem “childlike” in certain ways, it’s crucial to remember they’re an adult — and they can tell when they’re not being treated like one. Speak to your loved one in the same tone of voice you’d use when speaking with a friend or colleague. Avoid using baby talk, or terms of affection that could come across as condescending. And never talk about the person as if they aren’t there. Always assume your loved one can hear and understand you, because they usually can. So speak directly to them.
Speak in short, distinct sentences
Long and complex sentences can be hard for a person with Alzheimer’s to follow, so break up your thoughts into simple statements of a few words each. Pause briefly after each sentence, to give your loved one a moment to process what you’ve said (and respond if they want to). If they appear confused, try rephrasing the same statement using different words. Sometimes it takes a few tries to get that “click” of understanding — but if your loved one becomes frustrated or annoyed, don’t push it; just move on to a different idea.
Ask questions that are simple to answer
To avoid confusion, it’s best to ask just one question at a time. In the early stages of Alzheimer’s, your loved one may be able to answer open-ended questions, as long as you phrase them clearly. As the disease progresses, multiple-choice questions generally work better — for example, “Would you like fish for lunch, or would you like chicken?” In the later stages, however, you’ll probably have to stick with yes-or-no questions like, “Would you like a glass of water?” instead of “What would you like to drink?”
Avoid asking, “Do you remember…?”
Trying to remember a recent event can be frustrating for a loved one with Alzheimer’s. In many cases, they won’t remember; while at other times, they may not be sure whether they remember or not. They may feel embarrassed, and respond with a saving appearance statement (SAR) like, “Yes, of course I remember,” even if they don’t. At the very least, questions about memory are likely to put your loved one on the defensive — so spare them stress by saying, “I remember when…” and letting them join in if they remember, too.
Don’t correct, contradict or criticize
A person with Alzheimer’s will often struggle to remember words, dates, and experiences. They may talk about a person who’s passed away as if they’re still alive, or even insist something happened when it didn’t. While your first instinct may be to correct your loved one, that’s likely to put them on the defensive, and may even lead to a heated argument. In the disease’s early stages, a gentle reminder may be appropriate — while in the later stages, it’s better to avoid contradiction and criticism altogether.
Listen patiently without interrupting
It can take time for a person with Alzheimer’s to process what you’ve said, and find the words to respond. Give them at least a few seconds to answer, even if they appear to have “tuned out” or lost interest. In some cases, it may be helpful to offer suggestions for words they’re looking for — though it’s important not to put words in their mouth. With practice, you’ll get a feel for your loved one’s conversational rhythm, and it’ll start to feel more natural.
If the person gets upset, switch topics
Sometimes, a slight misstep in a conversation can provoke a sharp emotional reaction. A person with Alzheimer’s may become frustrated when they can’t think of a word, remember an event, or explain what’s on their mind. Certain memories can be deeply painful to revisit, and may trigger a burst of tears. People with Alzheimer’s may also become suspicious or even paranoid, and respond with outbursts of aggression. If the person you’re talking to becomes upset, don’t take it personally — just gently change the topic.
Pay attention to non-verbal cues
As Alzheimer’s progresses, gestures often become easier than words. If your loved one struggles to express themself verbally, encourage them to point or gesture to indicate what they’re thinking — then try to put that thought into words for them. In the disease’s later stages, on the other hand, almost all communication will be nonverbal. You can still show you care by holding your loved one’s hand, looking into their eyes, and speaking in a calm and soothing voice.
As you interact with a person who has Alzheimer’s, it’ll be helpful to minimize your expectations — both positive and negative. The disease affects everyone differently, and each person is unique. Many people with Alzheimer’s remain highly communicative for years, and tell vivid stories about their childhoods. Alternatively, your loved one may become withdrawn; or they may eagerly try to talk, even when they can’t find the words.
What’s most important is to tailor your approach to your loved one’s abilities and conversational rhythms. With respect, patience, and a little improvisation, you’ll soon get a feel for how best to communicate with your loved one, and make the most of the time you spend with them.