Twenty Questions and Conversation Games for People with Dementia

Many families want a game to play together that feels like conversation, not a test. Twenty questions and similar guessing games can work well, because the rules are simple and the talk can go anywhere. The trick is to reverse the usual roles: the person thinks of the answer, and you ask. This page explains how to run these games gently, and which conversation games suit people with dementia.

Why reverse the usual rules?

In a typical quiz, one person asks and the other must know. That puts the person with dementia in a position where they may fail, and failing can be upsetting. When they choose the object and you do the guessing, they are the expert. They hold the answer, they decide when to say yes or no, and they can enjoy watching you try.

The National Institute on Aging advises caregivers to use short, simple sentences, one question at a time, and a calm, patient tone. Those habits suit guessing games well.

How to play twenty questions, gently

1. Pick a theme from the person’s life, such as the kitchen, the garden, animals or the seaside.
2. Let them think of something and say it quietly, or show a picture card so you do not need to hear it.
3. Ask one yes-or-no question at a time. “Is it something you eat?” “Is it bigger than a shoe?”
4. Accept any answer. A nod, a shake of the head, or a laugh all count.
5. Make guesses out loud and enjoy them. If you guess right, celebrate together.
6. Offer hints when the person seems stuck: “It’s something in the kitchen.”
7. Never count the questions and never keep score.

If the person cannot follow the rules, switch to a simpler version: you name a few things and they point to the right one.

Good things to choose

• A favorite fruit, vegetable or flower
• An animal from the farm, the zoo or a pet they had
• A tool, such as a hammer, a rake or a sewing needle
• A piece of furniture or household item
• A place they know well, like a park or a town
• A piece of clothing they liked to wear

Avoid names of people, anything that might cause grief, and objects that could be dangerous or are easily confused.

More conversation games

• This or that. Offer two options and ask which they prefer: tea or coffee, the mountains or the sea, a red dress or a blue one. There is no right answer.
• Would you rather. Ask a gentle, light question: “Would you rather have a picnic or a dinner out?”
• Finish the saying. A familiar phrase with the ending left open. Try our finish-the-saying games for a guide.
• Name the place. Ask them to describe a favorite room, town or view, and invite you to picture it too.
• Open prompt cards. Our conversation cards give open prompts by theme, printable for the table.

For more ideas that draw on memory and life story, see reminiscence questions. For quiz-style fun done gently, see easy trivia for seniors with dementia, which uses choices and no scoring.

What if the person gets frustrated?

Stop, smile and say something like, “Let’s play something else.” Frustration is a signal to change the game, not to push harder. Our guide on how to play games with someone who has dementia explains how to change rules on the fly.

What games can and cannot do

Conversation games are enjoyable and social. They can help people connect and share stories. They do not treat dementia, slow it or prevent it. Keep the goal simple: a warm moment together.