Tips for effective communication with memory impaired loved ones


By Micha Shalev

Both family and paid caregivers may overlook various barriers to effective communication with impaired older adults and consequently misinterpret verbal and behavioral messages.

When someone has Alzheimer’s disease, or any other form of memory impairment, communication can become more difficult. Their understanding of what you are saying and their ability to make you understand their world can be highly variable and each person will react to different stimuli in different ways. This means we have to be sensitive to the way we present ourselves and how we give information when we talk with someone with Alzheimer’ s or other forms of dementia.

For the most effective way to talk and communicate with someone who has Alzheimer’s it is important to remember a few simple rules:

•Body language, communication and Alzheimer’s: Your facial expression, your body language and the tone of your voice become extra important when talking and communicating to someone with neurological problems. If a person with dementia feels threatened, undermined or confused by your communication with them, they may react in a negative way to your interventions. Conversation or information can increase agitation, undermine their confidence and increase their feelings of isolation.

•Environmental awareness aids communication. Is the lighting sufficient to aid communication? In conversation we usually look at the face and body of the person talking to us. It helps us to understand content and intent. Make sure you have some light on your face. Be aware about communication in a dark room through the night.

•Identify yourself and address the person by name. This helps someone with Alzheimer’s to orientate.

•Does the person with dementia have hearing or sight difficulties? Make allowances for visual and hearing deficits. Look into getting a medical evaluation and aids to assist communication.

•Make sure you have the person’s attention.

•Speak slowly, calmly and distinctly: For effective communication you need to balance distinctive speech without treating the person with dementia as a child, without shouting or becoming angry with them if they do not understand. Shouting also affects the tone of your voice and makes understanding more difficult. Do not get angry even if you find yourself becoming frustrated. We have all seen people talking too loudly at people with dementia — it’ s not nice and it really does not help their self-respect and confidence.

•Use simple, direct statements and information and words the person can understand. Do not give more than one instruction at a time. Do not press for an answer if that worries or confuses them. Ask questions that require a “yes” or “no”  response if that aids conversation and understanding.

•If you do not understand the content of their conversation, you can ask them to repeat it. Sometimes conversing with individuals with Alzheimer’s is not necessarily about understanding; it is about showing care, concern, inclusion and love towards them.

•Correcting wrong information: It is not necessary to constantly correct the validity of the person’ s statements if it includes wrong information.

Micha Shalev MHA is the owner of Dodge Park Rest Home at 101 Randolph Road in Worcester. He can be reached at 508-853-8180 or by e-mail at or you can view more information online at