Alzheimer’s takes language in a particular order: word-finding first, then comprehension of complex sentences, then the thread of a conversation. What survives longest is emotional tone. People stop remembering what was said and keep responding to how it felt.
Almost every useful communication technique follows from that one fact.
Before you speak
- Reduce competing noise. Turn the television off. Divided attention is much harder with dementia, and background noise can make speech genuinely unintelligible.
- Approach from the front, never from behind. Being touched by someone who appears from nowhere is frightening.
- Get to eye level. Standing over a seated person reads as authority, then as threat.
- Say who you are without being asked. “Hello Mum, it’s Rachel.” It removes a test they might fail, and the relief is visible.
- Check hearing aids and glasses. A surprising proportion of what looks like confusion is a flat hearing aid battery.
How to say it
- One idea per sentence. “Let’s have lunch.” Then, separately, “Shall we sit here?” Compound sentences lose people.
- Slow down, but don’t raise your voice unless they’re deaf. Loudness reads as anger.
- Wait. Longer than feels natural — ten seconds or more. Processing takes time, and filling the silence restarts the clock.
- Use closed questions when open ones stall. “Would you like tea?” beats “What would you like to drink?”
- Offer two options, not five. Hold up both jumpers.
- Use names, not pronouns. “Is John coming?” rather than “is he coming?”
- Show as well as tell. Hand them the toothbrush. Demonstrate the first movement. Visual cues often work when words don’t.
- Watch your face and body. Tone and expression are read accurately long after words aren’t. Sighing, checking your watch, and tension in your shoulders all land.
The difficult situations
The same question, over and over
Repetition usually signals anxiety rather than curiosity. The question is “am I safe, is something happening?” dressed as “what time is the appointment?”
Answer calmly the same way each time. Then address the anxiety: write the answer on a note they can see, or redirect to something absorbing. Saying “you’ve asked me that four times” achieves nothing except distress on both sides — they have no memory of asking.
Believing someone dead is alive
Correcting this delivers the bereavement afresh, every time. Don’t.
Respond to the emotion: “You’re missing your mum. Tell me about her.” Redirect into memory rather than into fact. This is not deception; it’s choosing kindness over accuracy in a situation where accuracy helps nobody.
Accusations — “someone’s stolen my purse”
Common, distressing, and a symptom rather than a judgement. The person has lost something and their brain has supplied an explanation.
Don’t defend yourself or argue. Say “that’s worrying, let’s look together.” Search with them. Keep a duplicate of commonly lost items if you can. Check the usual hiding places — many people with dementia hide valuables and forget.
Agitation and distress
Look for an unmet need before reaching for reassurance: pain, needing the toilet, hunger, thirst, too hot, too noisy, constipation, or an infection. Distress in dementia very often has a physical cause that the person can no longer report.
If it’s late afternoon, see sundowning. If it’s sudden and out of character, think infection and call the GP the same day.
Refusing personal care
Usually about fear, cold or dignity rather than the wash itself. Warm the room first. Explain each step before you do it. Keep them covered. Offer choices — flannel or shower, now or after breakfast. Try again in twenty minutes rather than insisting. See maintaining dignity.
Things to stop saying
| Instead of | Try |
|---|---|
| “Don’t you remember?” | “I was thinking about that day at the coast…” |
| “I’ve told you already.” | Answer again, calmly. |
| “Your mother died years ago.” | “You’re missing her. What was she like?” |
| “You’re wrong.” | “Let’s have a look together.” |
| “What do you want to do today?” | “Shall we go to the garden, or listen to some music?” |
| “Hurry up.” | Nothing. Slow down instead. |
When words run out
In the later stages, verbal communication may largely go. Connection doesn’t.
- Touch — a hand held, hand cream applied slowly, hair brushed
- Music from their teens and twenties. Musical memory is remarkably durable, and people who haven’t spoken in months sometimes sing
- Familiar smells — baking, a particular soap, cut grass
- Simply being present. Sitting together in silence is communication
Looking after yourself
You will lose your temper at some point. Nearly everyone does, and it doesn’t make you a bad son or daughter — it makes you a person who is tired. Step out of the room, take a minute, come back. They will not remember the moment; you will, so forgive yourself for it.
If this is happening often, you need a break rather than better technique. See respite care and carer burnout.
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Frequently asked questions
How should I talk to someone with Alzheimer’s?
Approach from the front at eye level, say who you are, reduce background noise, use one short idea per sentence, and wait longer than feels natural for a reply. Offer two choices rather than open questions, and use gestures and demonstration alongside words.
Should I correct someone with dementia?
Generally no. Correcting someone who believes a deceased relative is alive delivers the loss again each time, and arguing rarely changes the belief. Respond to the emotion behind what they said and redirect gently.
What do I do when they ask the same question repeatedly?
Answer calmly the same way each time and treat it as anxiety rather than curiosity. Writing the answer on a visible note often helps, as does redirecting to an absorbing activity. Pointing out that they’ve already asked causes distress and achieves nothing.
Why does my relative accuse people of stealing?
They’ve lost something and their brain has supplied an explanation. It’s a symptom, not an accusation about you. Don’t defend yourself — offer to look together, keep duplicates of commonly lost items, and check hiding places.
How do I communicate in the late stages?
Through touch, music from their youth, familiar smells and simple presence. Musical memory is particularly durable, and people who no longer speak sometimes still sing. Sitting quietly together is genuine communication.
The Care Panel is an independent publication. We are not a care provider and are not regulated by the Care Quality Commission, because we do not deliver care. Always check a provider’s own CQC registration and inspection report before you commit.
Written and fact-checked by The Care Panel. Last updated September 2026. Sources include the Alzheimer’s Society and Dementia UK. General information, not a substitute for medical advice.