The short answer
Talk somewhere quiet, face the person, use their name, and speak slowly in short, simple sentences. Ask one question at a time, offer two choices instead of open questions, and wait longer than feels natural. Do not argue, correct or quiz. Respond to the feeling behind the words, and use touch, pictures and gestures as speech becomes harder.
- Cut background noise and get eye contact before you start talking.
- Use short sentences, one idea at a time, and names instead of he, she or they.
- Offer a choice of two, or a yes-or-no question, rather than open questions.
- Wait for an answer. If they are not understood, repeat the same words, then try new ones.
- Do not argue or correct. Respond to the feeling behind what they say.
- As words fade, communicate through touch, tone, facial expression and shared pictures.
On this page (8 sections)
- What are the most important tips for talking with someone who has dementia?
- How should I start a conversation?
- How should I phrase what I say?
- How do I listen well?
- What if they say something that is not true?
- How does communication change as dementia progresses?
- Can pictures and activities make conversation easier?
- What if I lose my patience?
Dementia can make it harder to find words, follow a long sentence, or block out background noise. None of that means the person has stopped wanting to connect. Small changes in how you set up a conversation, how you speak and how you listen can make talking easier and calmer for both of you.
What are the most important tips for talking with someone who has dementia?
Get their attention, keep it simple, and be patient. If you remember only five things:
- Quiet the room and face them. Turn off the TV, sit at eye level, and use their name.
- Say one thing at a time. Short sentences, one idea, one question.
- Offer a choice of two. “Tea or coffee?” is easier than “What would you like?”
- Wait. Give more time to answer than feels natural, and try not to interrupt.
- Never argue or quiz. Respond to how they feel, not to whether the facts are right.
How should I start a conversation?
Set things up so the person can focus on you. The Family Caregiver Alliance guide recommends limiting noise first: turn off the radio or TV, close the curtains or door, or move somewhere quieter.
- Approach from the front. Coming from behind or the side can startle.
- Say who you are. “Hi Dad, it’s Sarah, your daughter.” This saves them from searching for your name.
- Get down to their level. If they are sitting, sit or kneel so your eyes are level.
- Check your face and tone. The National Institute on Aging (NIA) advises being aware of your tone, volume, facial expression and body language, and aiming for a warm, matter-of-fact manner.
- Make sure glasses and hearing aids are in. It is hard to follow a conversation you cannot fully see or hear.
How should I phrase what I say?
Use simple words, short sentences and a calm, low voice.
- One idea per sentence. “Let’s put on your coat. Then we’ll go outside.” Not both in one breath.
- Use names, not pronouns. “Aunt Jean called” is clearer than “She called.”
- Pitch lower, not louder. The Family Caregiver Alliance suggests a lower voice rather than a raised one.
- Repeat, then rephrase. If they did not understand, repeat the same words once. If that does not work, wait a moment and try different words.
- Show as well as tell. Point to the cup, hold up the two sweaters, or demonstrate the first step.
- Talk to them, not about them. The NIA cautions against talking about the person as if they are not there, and against “baby talk”.
The NIA suggests simpler versions of common questions. Here are examples in that spirit:
| Instead of | Try |
|---|---|
| “What do you want for dinner?” | “Do you want fish or chicken?” |
| “How are you feeling?” | “Are you feeling tired?” |
| “Are you hungry?” | “Dinner will be ready in five minutes.” |
| “That’s not how you do it.” | “Let’s try it this way.” |
| “Do you remember our trip to the lake?” | “I was thinking about our trip to the lake. Tell me what you liked about it.” |
| “I already told you.” | Answer again, kindly, as if for the first time. |
How do I listen well?
Listen for the meaning and the feeling, not just the words.
- Wait. Silence is often thinking time. Count slowly to ten before stepping in.
- Offer a word only if they are stuck. The Family Caregiver Alliance says it is fine to suggest words when someone is struggling.
- Check what you heard. The Alzheimer’s Association guide to communication suggests looking for the meaning behind their words and restating it to check you understood. “You’re worried about the car?”
- Watch their face and body. As speech gets harder, the NIA notes, facial expressions may show sadness, anger or frustration more clearly than words.
- Take concerns seriously. Even if a worry is based on a mistaken fact, the feeling is real.
What if they say something that is not true?
Do not argue. You are unlikely to win, and the person may end up feeling embarrassed or frightened. Instead, connect with the feeling, then gently move on.
The Family Caregiver Alliance suggests acknowledging the emotion before you redirect. For example, if your mom insists she needs to pick up the children from school:
- Instead of: “Mom, your kids are grown. That was forty years ago.”
- Try: “You were always such a caring mother. Tell me about picking them up. Shall we have a snack first?”
The Alzheimer’s Association also advises not to argue over statements you disagree with. Pick your moments: if a mistaken belief is harmless, let it be.
How does communication change as dementia progresses?
Needs change over time, so adjust your approach. The Alzheimer’s Association describes three broad phases:
| Stage | What helps |
|---|---|
| Early | Don’t assume they can’t communicate. Include them in conversations, speak to them directly, ask what support they want, and use humor if it helps. |
| Middle | One-to-one talks in a quiet place. Speak slowly, keep eye contact, use yes-or-no questions, give step-by-step instructions, and don’t criticize or correct. |
| Late | Approach from the front and say who you are. Encourage pointing and gestures. Use touch, sounds, sights and smells. Never talk as if they aren’t there. |
Every person is different, and the same person may have good and hard days. Respond to how they are right now, not to a label.
Can pictures and activities make conversation easier?
Yes. A shared picture takes the pressure off and gives you both something to look at and point to.
- Picture prompts. Conversation Cards offer pictures with open questions that never quiz.
- Family photos. Photo Pairs turns photos you choose into a gentle matching game, which often sparks stories.
- Familiar sayings. Finish the Saying uses well-known American sayings, followed by a talking prompt.
- Matching games as a backdrop. Picture Pairs gives your hands something to do while you chat.
See how to play games together and reminiscence activities for more. For visits and calls, read our guides to visiting and phone and video calls.
What if I lose my patience?
It happens to everyone. The NIA suggests that if you become frustrated, you take some time to calm down. Step into another room, take a few slow breaths, and come back when you can. You can always start the conversation again, and the person may well respond to your calmer mood. If frustration is becoming constant, that is a sign you need more support, not that you are failing. Our guide to caregiver self-care has places to turn.
Common questions
What should you not say to someone with dementia?
Avoid quizzing ("Do you remember...?"), correcting ("That's wrong"), reminding them of losses ("I already told you") and talking about them as if they are not there. Avoid baby talk. These tend to cause embarrassment or distress without helping.
Should I correct them when they get facts wrong?
Usually not. If a mistaken fact is harmless, let it go. Arguing rarely changes the person's mind and often makes them upset. Focus on how they feel and what they need right now.
What do I do when they cannot find the word?
Give them time first. If they are clearly struggling, it is fine to gently offer a word or guess what they mean and check. Pointing, gestures and pictures can also help.
How do I talk with someone in late-stage dementia who rarely speaks?
Approach from the front, say who you are, and use a calm voice and gentle touch. Watch faces and body language for feelings. Your presence, a familiar song or holding hands can communicate a great deal without words.
Sources
We link to the organizations and studies this page relies on. Each was checked when the page was updated.
- Communicating With Someone Who Has Alzheimer's Disease · National Institute on Aging
- Communication and Alzheimer's · Alzheimer's Association
- Caregiver's Guide to Understanding Dementia Behaviors · Family Caregiver Alliance