It can feel overwhelming when a loved one receives a dementia diagnosis; all aspects of life change, including conversations. While there is no blueprint for navigating conversations with dementia patients, family members should avoid saying the following to someone with dementia.
What Not to Say to People with Dementia
1. “Do You Remember…?”
Someone with memory problems will experience difficulties remembering past events. Not being able to remember core memories can be disheartening and scary, which can cause the person experiencing memory loss to lash out or withdraw.
2. “That’s Not Right./You’re Wrong.”
People with dementia will not always remember past events perfectly. When someone tells a story wrong or makes up events, it’s important not to contradict them. Doing so can make them feel embarrassed and defensive, which can lead to aggressive behavior.
3. “That Person Passed Away.”
A family member living with Alzheimer’s disease or another type of dementia may not always remember that a loved one has passed. Instead of correcting someone when this happens, it’s better to simply enter their reality where this person is still alive and speak of the deceased in the present tense.
4. “Stop Being Difficult.”
People living with cognitive impairment might behave differently—in some cases, aggressively. This behavior is not an active choice, however, so it’s best to avoid calling these individuals “difficult” or “mean” or some similar descriptor.
5. “What Do You Want to Do?”
“What do you want to do?” might seem to be an innocuous or even compassionate question to ask. Open-ended questions can cause confusion to those living with dementia, though, turning what seems to be a simple question into a minefield of confusion, embarrassment, and defensiveness for the person with dementia. Instead of open-ended questions, it is better to ask direct questions with only two options, such as simple “Yes or No” questions.
6. “I/You Already Said That.”
One of the hallmark early symptoms of dementia is forgetfulness in conversations. This forgetfulness can lead to dementia patients not remembering that they have already said something or not remembering something their conversational partners have just mentioned.
Conversational partners in these situations need to remember that, to the dementia patient, it feels like the first time they are saying something or receiving certain information. As such, it’s best to not point out when repeat stories or questions occur.
7. “Do You Know Who I Am?”
Not being able to remember important names, places, and more can be incredibly frustrating and exhausting. It’s best not to add to that frustration by asking dementia patients if they remember someone. They can take it as mockery and become embarrassed and defeated, leading to lashing out or withdrawing from conversations entirely.
7 Tips for Talking with a Person Living with Dementia
1. Avoid Open-ended Questions
People with declining cognitive abilities are less likely to understand and calmly respond to open-ended questions. A better approach is to ask “Yes or No” questions or give someone only two options to choose from. For example, instead of asking, “What do you want for lunch”?,” ask, “Do you want soup or salad for lunch?”
2. Use Simple Sentences
Good communication means meeting people where they are at. For people experiencing cognitive decline, that may mean simplifying sentences; long sentences may confuse them, leading to frustration and potential friction.
For example, instead of saying, “Oh first I went to the bank and then I went to the park where I saw people walking their dogs, which reminded me that I need to pick up dog food later,” a better way to approach the conversation could be, “I went to the bank today… I went to the park…”
3. Find the Right Tone of Voice
Using the right words is only part of the equation when talking to someone with dementia. Delivery can also significantly impact conversations. It’s easy to become frustrated when a loved one forgets important memories or dates, but using annoyed or even angry tones can make that person defensive and derail pleasant visits.
When feeling overwhelmed, it can be a good idea to stop talking or take a small walk to calm down.
4. Validate Emotions
One of the best ways to improve quality of life for someone with dementia is to craft a supportive environment where their feelings are validated. It may not be easy to do so, especially when the individual accuses others of theft or something else unsavory. Directly reassuring the person that their feelings matter, however, and potentially offering apologies can go a long way to making the person feel comfortable and more secure in their often-confusing day-to-day reality.
For example, if a person with dementia accuses their child of theft, the immediate reaction may be to deny it. However, a better response can be “I am sorry your jewelry is missing. That must feel awful.”
5. Distract
It is not always possible to reason with someone living with dementia. In cases where people living with dementia become hostile and confrontational, it may be best to distract them. For example, if an elderly parent is falsely accusing their adult children of stealing jewelry, the children could try saying, “Oh no, that must feel terrible. Did you know that Bob moved to a new house?” The sudden switch in topic can diffuse tension, causing the person with dementia to become less stressed and more amicable.
6. Repeat
Repetition is a great conversational strategy for all stages of dementia. Repetition can include both repeating questions (e.g., “Do you want eggs or toast?… Do you want eggs or toast?”) and rephrasing what the other person has said to minimize misunderstandings (e.g., “You want to have lunch now, correct?”).
7. Be Patient and Forgiving
While memory loss can be confusing, scary, and frustrating for everyone, it can be especially so for dementia patients. A little extra grace can go a long way to making a confusing situation a little kinder for the dementia patient.
It’s also important for carers and family members to be patient and forgiving of themselves. Watching a loved one receive a dementia diagnosis can be overwhelming. It’s impossible to always know exactly what to do and say. Being patient and forgiving of misspeaking is a core component of communicating with and supporting someone with dementia.
Disclaimer: This article is for informational purposes only.