What You Should NOT Say to Someone with Dementia

Caregiver Resources
What You Should NOT Say to Someone with Dementia image


Communicating effectively with someone living with dementia can be challenging. It requires understanding, patience, and a compassionate approach. This guide is designed to help families and caregivers navigate these challenges. It offers practical advice for adapting communication methods and avoiding common mistakes that can lead to confusion or distress in individuals with dementia. By focusing on respect, empathy, and the unique needs of each person, we create more meaningful and comforting interactions.

Understanding How Dementia Affects Communication

What is Dementia?

Dementia is not a specific disease but a general term that describes a group of symptoms associated with a decline in memory, reasoning, or other thinking skills. It involves a deterioration in cognitive function beyond what might be expected from normal aging. It affects a person’s ability to perform everyday activities and can impact their communication skills, behavior, and emotions.

The Effects of Dementia on Communication

Dementia affects communication in various ways, influencing how individuals express themselves and comprehend others. As dementia progresses, these changes become more pronounced, impacting both verbal and non-verbal communication.

Verbal Communication Changes:

  • Word-Finding Difficulties: Individuals with dementia often struggle to find the right words, leading to pauses or substitutions with unrelated words.
  • Repetition: Repeating questions, stories, or phrases is common as short-term memory deteriorates.
  • Echolalia: Some individuals may repeat words or phrases they hear, a behavior known as echolalia.
  • Altered Sentence Structure: The ability to construct coherent sentences may diminish, resulting in simpler or fragmented speech.

Non-Verbal Communication Changes:

  • Facial Expressions and Body Language: People with dementia may have difficulty interpreting facial expressions and body language, or they may use less expressive gestures themselves.
  • Tone of Voice: Understanding and interpreting tones of voice can become challenging, and their own tone may become monotonous or inappropriate to the context.

Understanding and Processing Delays:

  • Slower Processing: It may take longer for a person with dementia to understand what’s being said, requiring patience and avoiding rushing them in conversation.
  • Difficulty with Complex Ideas: Complex or abstract ideas can be hard to grasp, necessitating simpler, more concrete language.

Emotional Responses and Misinterpretations:

  • Heightened Emotional Responses: Misunderstandings or an inability to communicate effectively can lead to frustration, agitation, or withdrawal.
  • Misinterpretation of Intent: Individuals may misinterpret jokes, sarcasm, or idiomatic expressions, which can lead to confusion or hurt feelings.

Understanding these changes in communication is vital for caregivers and family members. Adapting our approach to communication—by simplifying language, being patient, and focusing on non-verbal cues—can help maintain a connection and ensure that interactions are as positive and effective as possible. Here’s a few suggestions on how to accomplish this: 

Avoiding Common Communication Mistakes

Misconceptions about dementia can lead to ineffective and even harmful communication practices. It’s important to recognize that each individual’s experience with dementia is unique, and a one-size-fits-all approach to communication does not work. Instead, understanding the specific ways in which dementia affects an individual can guide more effective and compassionate communication.

Phrases to Avoid and Why

This section addresses specific phrases and why they can be counterproductive or even harmful when communicating with someone living with dementia.

“You’re Wrong”

Contradicting someone with dementia can lead to confusion and distress. It’s better to gently redirect the conversation to avoid contradiction and maintain a peaceful environment​​.

“Remember When…?”

Asking about specific past events can lead to frustration for someone who can’t recall. Share your memories as statements to create a positive conversation without pressuring them to remember​​.

“But You Don’t Look Like You Have Dementia”

This kind of statement can be invalidating. It’s important to acknowledge that dementia’s impact is not always physically visible but is very real for the person experiencing it​​.

“They Passed Away”

Reminding a person with dementia about the death of a loved one can cause unnecessary distress. If they ask about a deceased individual, it’s often more compassionate to redirect the conversation gently​​.

Avoid Using Pet Names or Diminutive Terms

Using terms like ‘honey’ or ‘sweetie’ can feel patronizing. It’s respectful to address them by their preferred name, maintaining their dignity and individuality​​.

“I’ve Just Told You That” or “You’ve Asked Me That Already”

Repeating questions or statements is common in dementia. Responding with patience and refraining from showing frustration is vital for their sense of comfort and self-worth​​.

“Her Dementia is Getting Worse”

Discussing a person’s dementia condition in their presence as if they are not there can be very demeaning. Always respect their presence and avoid talking about them as though they are not part of the conversation​​.

“Let’s Get Your Shoes On and Get to the Car”

Instructions with multiple steps can be overwhelming. Break down tasks into simpler, manageable steps to avoid confusion and anxiety​​.

Empathetic Communication Strategies

Effective communication with a loved one living with dementia requires empathy and understanding. Connect on their terms and respect their current reality. Here are some strategies to help foster this connection:

Using Positive Language

Use affirming words: Phrases that affirm the person’s feelings and experiences can create a positive atmosphere. For example, saying “You seem really happy talking about your garden,” acknowledges their feelings.

Focus on abilities, not losses: Emphasize what the person can still do and find joy in, rather than what they may have lost. Celebrate small successes and daily joys.

Avoid negative phrases: Phrases that highlight limitations or decline can be discouraging. Instead, reframe statements to be about current abilities and strengths.

Redirecting Conversations

Change topics gently: If a conversation becomes distressing, smoothly transition to a more pleasant or neutral topic. For instance, if a discussion about recent events becomes confusing, shift to talking about a favorite activity.

Use familiar topics: Engage in conversations about topics that are familiar and enjoyable to them. This could be reminiscing about a favorite vacation or discussing a beloved hobby.

Utilize nonverbal cues: Sometimes, words are not necessary. A warm smile, gentle touch, or sitting quietly together can be powerful ways of connecting.

Active Listening

Show that you are listening: Make eye contact, nod, and react appropriately to show that you are engaged in the conversation.

Encourage expression: Let them express their thoughts and feelings without rushing them. Validate their emotions, even if the topic seems trivial or repetitive.

Be patient: Understand that it might take longer for them to find words or articulate thoughts. Patiently wait for them to finish their sentences.

Creating Comfort and Trust

Provide reassurance: People with dementia often feel anxious or unsure. Reassuring them that they are in a safe place and with someone who cares can be comforting.

Build trust with consistency: Maintaining a routine in interactions can build trust. Consistently visiting at the same time or starting conversations with a familiar phrase can help.

Respect their reality: Avoid correcting their version of reality. If they speak about past events as if they are current, it’s often more compassionate to simply go along with their perspective.

Nonverbal Communication

Use body language: Positive body language such as nodding, smiling, and open postures can communicate empathy and understanding.

Touch as a communication tool: A gentle touch on the hand or shoulder can be reassuring and convey care, provided the person is comfortable with physical contact.

Facial expressions matter: Often, a person with dementia will respond more to the tone of your voice and your facial expression than to the actual words spoken. Ensure your facial expressions match the emotion you wish to convey.

Incorporating these empathetic communication strategies can greatly enhance interactions with individuals living with dementia, making them feel valued, understood, and cared for. At Koelsch Communities, we train our staff in these techniques, ensuring our residents receive the highest standard of compassionate care.

Closing Thoughts

Communicating with someone living with dementia requires empathy, patience, and understanding. By avoiding certain phrases and adopting supportive communication strategies, we can significantly improve their quality of life.

About Koelsch Communities

Since 1958, Koelsch Communities has been dedicated to providing exceptional care and living experiences for our residents. Our commitment to respect, dignity, and compassion is the cornerstone of our philosophy. As a family-owned and operated company, we ensure each resident is treated as an individual, reflecting our ethos of being ‘ladies and gentlemen serving ladies and gentlemen’. Discover more about our Assisted Living and Memory Care programs and see why we are recognized nationally for our innovative care techniques and excellence in senior care.


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