Conversation Starters

Try these communication pointers to connect to loved ones with dementia

When Peter Zollo’s mother passed away in December, relatives spoke at the Zoom funeral about the happiest years of her life — before she suffered from memory loss due to dementia. Yet, Zollo chose to talk about her final years, which were also happy — just in a different way. 

“We had quality, wonderful moments up until the end,” says Zollo of Highland Park. “Just because your loved one suffers from memory loss doesn’t mean that you cannot have meaningful and joyful moments together. Their character is still intact. Yes, they have a significant disability. But who they are, what they believe in, and what’s core to them does not change.” 

Still, it takes time for some families to understand memory loss is not necessarily a thief in the night who stole their loved one. It may merely be a barrier to communication, an obstacle that experts say you can get around. 

When communicating with someone with memory loss, keep these tips in mind.

Set the scene

Ambient noise may distress individuals with memory loss. 

Whenever possible, speak to them one-on-one in a quiet place, says Heather Lantry, executive director and owner of Right at Home North Shore Chicago Metro.

Ask them one question at a time — their brain needs time to process — and patiently wait through the silence. Resist temptation and don’t offer the word you assume they’re searching for. Only help if they request it. Otherwise, even though it may feel awkward, just be with them as they get to the word. 

Lead with kindness

Don’t argue with, criticize, or judge them. “People with Alzheimer’s and other dementias may lose their ability to communicate and express emotion,” Lantry says. “But they still receive it. They will feel that love, just as they’re going to feel that frustration and anger.” 

Be sensitive to their feelings and don’t use the word “remember,” as it points out their memory loss, says Hadi Finerty, senior manager of education and community volunteers for the Alzheimer’s Association Illinois Chapter. 

“A lot of times, when people are having conversations, we hear, ‘I repeated that. Don’t you remember? I just said it five minutes ago.’ Of course, they don’t remember,” Finerty says. “We shouldn’t be having conversations like that.” 

Converse respectfully

Be polite, and always include your loved one in conversations, says Lee Moriarty, lllinois state long-term care deputy ombudsman and a former long-term care dementia consultant. 

Even though your loved one has memory loss, they want to be treated like an adult, not a child. Talk to your loved one, instead of talking around them. “Don’t say, ‘Hey, Dad, what does Mom want for breakfast?’ when she’s sitting right there. Ask mom directly,” Moriarty says. 

But make it easy, she adds, by giving mom two choices — do you want eggs or oatmeal for breakfast? — rather than asking an open-ended question that can lead to frustration. 

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“Who they are, what they believe in, and what’s core to them does not change.”

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Also, don’t ask questions that have right or wrong answers, Moriarty says. Stick with questions that relate to emotions. Replace “What did you eat for breakfast?” with “How was breakfast?” They might reply with something completely unrelated, but the open- ended question opens the door for them to lead the conversation. 

Meet them where they are

When an individual confuses the past for the present, relive those memories with them, says Benjamin Surmi, director of culture and education at Koelsch Communities. Instead of contradicting them, ask them about their reality: where they are, what they like about it, and how it makes them feel. 

If your loved one wonders why their mother never comes to visit, don’t tell them she died 20 years ago, Lantry cautions. They may grieve all over again. Reassure them and redirect them with preferred activities, such as saying, “I bet you miss her. Let’s look at your photo albums together.”

Use body language

To communicate with loved ones who are unable to speak, use more expression in your interaction with them, Surmi says. Speak in a soothing manner and mix in eye contact and an occasional firm, tender touch on the arm. It lets them know they matter. 

However, if their dementia is at a later stage, the less you speak the better, says Liz Nava, certified dementia practitioner and certified nursing assistant with Right at Home. “They don’t have the wiring to connect everything you’re trying to tell them,” she says. Use pictures to illustrate what you’re attempting to communicate, because it’s easier for them to make the connection. 

You can also communicate by engaging their senses in activities that elicit memories. Look at photo albums together, listen to their favorite music, or eat foods they liked in childhood, Finerty recommends. Just be sure those memories are happy ones and not cues that trigger anger, sadness, or loss. 

By reframing conversations and exercising empathy and patience, you can reduce the common frustrations that memory loss causes. Communication will be a more positive experience for everyone.