Verbal communication with Alzheimer’s sufferers


By Micha Shalev

As the Alzheimer’s disease progresses, the person with Alzheimer’s disease may develop problems in expressing what he is thinking, his needs or wishes. He may have difficulty naming things or following directions because he cannot understand your instructions or cannot remember what you told him. He will be dependent on your ability to interpret and use language effectively.


•The patient cannot express his thoughts, has trouble thinking of the names of objects, or may not understand the meaning of words.

•He fails to recognize family, staff, even himself.

Micha Picture - Copy•He seems unable to interpret or make use of environmental cues.

•He cannot remember what just happened.

•He loses the ability to understand abstract or complex material.

•He has limited attention span and is easily distracted.

•He repeats questions, words, phrases, and gestures over and over and may echo what others say. He is easily moved to laughter, tears or anger.


•To compensate for the patient’s loss of skills and to develop specific skills in communicating both on a verbal and non-verbal level.

Suggested approach:

•Speak slowly and concisely. Keep message simple. Do not use baby talk or condescending language.

•Ask one question at a time. Give the individual time to respond. If the person appears inattentive, he may be trying to process the information. Do not rush the person.

•If you must repeat a question or instruction, repeat it exactly. Otherwise, the person will view it as totally new information.

•Be mindful of the tone in your voice. If you are tired, impatient or upset, the Alzheimer’s person will be sensitive to this and react to your feelings rather than to your words.

Do not quiz or drill the person. If he/she has difficulty, remembering, this may prompt a catastrophic reaction. Instead, ask simple questions which can be answered by “yes” or “no.”

Avoid expressions that may be confusing to the individual such as, “hop into bed” or “run down the hall.”

Use concrete, familiar words.

Give the Alzheimer’s person one instruction at a time. Many tasks that seem simple, such as brushing your teeth, actually consist of a series of steps. Some persons may require you to break down the task and go through each step one at a time.

When a patient seems focused on one word or phrase, ask family members about its meaning.

Do not accuse the person of lying when he incorrectly relates information. Confabulation or “filling in the holes” is his way of coping with being unable to remember.

If you do not understand what the person is saying, respond to the “feeling content” of his message, such as fear, anger or frustration.

Do not talk about the person in his presence as if he is not there.

Use a friendly, warm approach but always treat the person in a dignified, respectful manner. Do not use demeaning names such as “pops,” “honey,” or “granny.”

Micha Shalev MHA CDP CDCM CADDCT is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester. He is a graduate of the National Council of Certified Dementia Practitioners program, and well known speaker covering Alzheimer’s and Dementia training topics. He can be reached at 508-853-8180 or by e-mail at or view more information online at Read more at