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Communicating and Alzheimer’s Disease

by Kathy Macaraeg

One of the challenges of caring for someone with Alzheimer’s disease is effectively communicating with them. They may have difficulty expressing their needs or the caregiver may not know how to address their changing ability. Caregivers can also get annoyed or frustrated because their caree repeats words or forgets the words for common items.

To make communication go more smoothly, it helps to understand what the common challenges are, and then move forward with solutions. Once you understand the challenge, it can be easier to communicate with them. You realize what they are experiencing is a normal part of the disease, and not them.

I had a client who did her best to hide her communication challenges. She was actually really good at it. She would throw out a random word if she didn’t remember the word she wanted and would change the subject before her children realized she was struggling. They thought their mom was being difficult, because she was so good at it. It took a two week visit for her daughter to realize that her mom was not in a position to live alone anymore – not due to communication, but due to other deficits.

Common Communication Changes with Alzheimer’s Disease

  • Inability to name objects
  • Difficulty in finding the correct word for objects, places or people
  • Inability to recognize a word or phrase
  • Using a general term instead of specific words and descriptions are vague
  • Becoming stuck on ideas or words and repeating them over and over
  • Easily losing their train of thought
  • Using inappropriate, silly, rude, insulting or disrespectful language during conversation
  • Increasingly poor written word comprehension
  • Gradual loss of writing ability
  • Combining languages or returning to native language
  • Decreasing levels of speech and use of nonsense syllables
  • Reliance on gestures rather than speech


Studies show that people with Alzheimer’s disease retain a strong desire to communicate, despite their challenges.

Communication Techniques for Alzheimer’s Disease

  • Distraction or Redirection: Attempt to engage them in a different conversation or activity.
  • Address the Underlying Feeling: Inquire about feelings – “You sound like you miss your mother,” or “Are you worried about your mother?”
  • Ignore the statement: It may not always add value to respond. Sometimes the most helpful response will be no response.
  • Bend the truth: While we’ve always been taught that lying is wrong, sometimes, it makes sense when speaking to someone with Alzheimer’s disease. They may still believe their mother is alive and when you tell them the truth it can be upsetting. Sometimes, accepting their reality that their mother is still alive is easier for them than upsetting them. If lying is the only way to relieve distress and no other measures have been successful, then it may be justified.

Components for Simplifying Communication with Persons with Alzheimer’s Disease

  • Patience
  • Show your interest in the subject
  • Offer comfort and reassurance
  • Listen for a response
  • Avoid criticizing, correcting or finishing their thoughts
  • Avoid arguing
  • Offer a guess as to what they need
  • Limit distractions
  • Encourage non-verbal communication
  • Be calm and supportive
  • Focus on feelings, not facts
  • Pay attention to your tone
  • Identify yourself and address the elder by name
  • Speak slowly and clearly
  • Use short, simple, familiar words and short sentences
  • Ask on question at a time
  • Allow enough time for a response
  • Avoid pronouns (he, she, they) and negative statements
  • Use non-verbal communication such as pointing and touch
  • Offer assistance as needed
  • Be flexible and understanding


I have worked with many clients who had Alzheimer’s disease and am a Schmieding Alzheimer’s and Dementia Caregiver. I have used all of these techniques in communicating with my clients and found them to be useful. As an outsider, it can be easier to communicate with someone with Alzheimer’s disease, versus their family who knew the person they were. Hopefully, these suggestions will make communication easier for your family.

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