3.7 Strategies to help with communication changes

Communication changes are common in dementia and can be especially noticeable early in the course of dementia for people with young-onset dementia, primary progressive aphasia or dementia affecting the temporal lobes – the language centre of the brain. The strategies below can help reduce frustration and keep conversations meaningful for both of you.

Give time and reduce pressure

People with dementia may need more time to process information and find words.

• Pause after asking a question. Only repeat if necessary.
• Avoid jumping in to finish sentences, unless the person signals they want help.
• If they get stuck, gently offer the first word or a choice (“Did you mean the kitchen or the garden?”).

Simplify without ‘talking down’

It’s important to keep communication respectful and age appropriate.

• Use shorter sentences, one idea at a time.
• Break down complex information into steps.
• When you’ve communicated something, check their understanding with neutral questions like, “Does that make sense?”

Reduce distractions

Busy or noisy environments can make communication much harder.

• Turn off the TV or music during conversations.
• Move to a quieter room or sit side-by-side rather than across a busy café table.
• Reduce visual clutter if the person finds it distracting.

Use multiple cues

Words aren’t the only way to communicate. Non-verbal language such as facial expression, gestures, pointing, photos, and objects all can support effectively getting your message across. Visual checklists, (e.g., using photos of morning routine tasks or steps for making lunch) can reduce confusion.

Support word-finding

Word-finding problems can be one of the most frustrating symptoms for people living with dementia. Supporting word finding includes strategies such as:

• Asking the person to describe the item, such as, ‘What colour is it?” or “can you show me what you do with it?”
• If you know what they are talking about, rather than give the word, try “It’s round… we used it yesterday…”.
• If needed, keep commonly used items labelled and/or visible.
• Use yes/no questions or offer two options to reduce cognitive load. For example, “Would you like to wear jeans or shorts? Would you like to go for a walk or watch a movie?” This also helps avoid decision fatigue.

Adapt group conversations

Social interaction is important for brain, and mental health. However, social situations can become daunting when people talk quickly or interrupt.

• Give brief context (e.g. “We’re talking about plans for the weekend”).
• Slow the pace, make space for the person to speak, or summarise key points.
• If needed, step in politely: ‘Can you please give us a moment, John just needs a bit of time to find the words.’

Plan around cognitive fatigue

Cognitive fatigue – when the brain simply gets tired – is common in dementia.

• Have important discussions earlier in the day or after rest.
• Keep complex conversations brief or split them over a few smaller chats.
• Avoid rapid changes of topic.

Maintain connection, even when words are hard

Communication is more than language. Shared routines, music, touch (when welcomed), or doing activities together can keep connections strong. Some people prefer texting or writing when spoken expression is difficult.

Speech Pathologists are health professionals who specialise in language and communication difficulties. They can address specific concerns and support better communication. If you use a private speech pathologist, a GP Chronic Condition Management plan may help with the cost of treatment.

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