Talk To Me: Effective Communication Strategies for Engaging Individuals with Dementia

May 12, 2025May 12, 2025

Submitted by Lori K. Yauch
M.A., CCC-SLP
Owner/Manager
Meaningful Memory Maker

“Talk to me quietly, peacefully; I don’t want to fight. Talk to me nice and slow, so I’ll know how to make it right.” (Barry Manilow, Marty Panzer, 2001)

This quote encapsulates the essence of effective communication with individuals, particularly those living with dementia. It highlights the importance of a calm and gentle approach to communication, which can significantly enhance interaction and reduce the likelihood of conflict. This approach necessitates not only effective communication skills but also a deep well of patience and compassion, two essential qualities that are not just desirable but integral for caregivers of individuals with dementia. Understanding the unique challenges faced by individuals with dementia can foster empathy and patience in caregivers, making them feel valued and integral to the care process.

Reconnecting

As I prepare to move from my home in Florida to another state, I am taking the time to connect and reconnect with friends to say “goodbye,” with the promise to stay in touch through various technological channels.

During one of these “reconnecting” conversations, my friend mentioned she would be giving an in-service presentation to a group of new young caregivers at an assisted living facility. She asked if I had any tips to help these caregivers communicate effectively with their clients on their dementia journey.

When you ask a speech-language pathologist, especially one who has specialized in dementia care for 25 years, a question like that, you should be prepared to receive a wealth of information. I sat down to compile a list of tips she could share.

This list, which inspired this article, can help improve interaction, promote communication and engagement, and decrease the risk of adverse behavior. However, it’s important to note that implementing these strategies may not always be straightforward. Caregivers may encounter resistance, forgetfulness, or other challenges. But with patience and practice, these strategies can be beneficial when caring for individuals with dementia.

Talk To Me, Peacefully

Begin in a quiet, well-lit, and open space. Approach from the front, look directly at your care receiver (“Sally”), and introduce yourself, being sure to describe your connection. Good Morning, Sally. My name is Elizabeth. Yes, like Elizabeth Taylor, I’m your nurse’s assistant (CNA, PCA). I’m here to help you prepare for your day.”)

When you introduce yourself at every interaction and link your name to something familiar, Sally is more likely to recognize you, allow you into her space, and accept your help.

Talk To Me Nice and Slow. Tell Me What to Do

Speak slowly, telling Sally precisely what is to be done. (“Let’s get up, get washed and dressed.”) Then, proceed slowly with the first task: Getting up. When completing any task, use one-step directions: “Sit up. Now scoot to the edge of the bed. Push up from the bed. Stand up. Reach for the walker.” If assistance is needed to stand, remember to ask permission. “May I take your arm to help you stand?”

Help Me Understand

When completing any task or engaging in a simple exchange regarding requests or questions, ask yes/no questions, use gestures and repetition, and provide a choice of two options. For example, you can ask, “Do you want to wash your face or brush your teeth?” Or “Would you like coffee or juice?” Providing these choices increases Sally’s understanding of the task, increases her focus, and allows her a sense of control over her daily routine. Providing this independence to Sally decreases the burden of care on the caregiver.

Take Me By The Hand

As you and Sally transition from the morning routine of getting ready for the day to the first meal, ask, “Are you ready for breakfast? May I take your hand as we walk?” During the walk to the dining room, reminisce with her about her favorite foods or waking up on cold mornings and being greeted by Momma with a kiss and a cup of hot cocoa. Engaging in these reminiscing moments not only connects you with Sally’s past but also shows your compassion as a caregiver.

At breakfast, set a simple table: One cup, one white plate on a colored placemat, and one utensil. Limit the number of foods on the plate to two or three. Simplicity in the presentation of both the setting and the meal reduces distractions and encourages consumption.

Help Me Get It Right

As the morning routine transitions into afternoon activities, help Sally choose activities that are interesting to her, engaging, facilitate communication, and support her current thinking skills. These activities can include but are not limited to sing-a-longs (which supports automatic chains of speech), trivia (which supports long-term memory), an afternoon movie (classic movie musicals are the best facilitators of language and cognitive skills due to their simple plots, bright colors use of simple language, and opportunities for reminiscing.)

If Sally declines a group activity, offer her a quiet afternoon on a couch with you, browsing through her favorite family history book. This engaging activity may bring her the greatest joy. Reminiscing and sharing her stories has no cognitive load – there are no wrong answers. Her memories are hers to keep or express as she chooses. As her dementia journey progresses, the one thing she knows is who she was and the life she lived. When you give her an avenue to express it, through reminiscing, that is the thing Sally can get right.

I Need to Talk To You

As Sally’s communication skills change, she may no longer be able to reminisce with you in traditional ways, such as looking at photos, telling stories, or singing songs. However, she can still “talk” and share memories with you in other ways. When you ask Sally to help with simple chores like setting the table, folding laundry, rolling out cookie dough, and stirring the batter for her grandson’s birthday cake, you give her a sense of purpose and pride in a job well done. Working together also strengthens the connection between you and Sally while providing you with some relief as a caregiver, knowing she is safely occupied in an enjoyable activity. These shared tasks can serve as a catalyst for reminiscing, allowing you to share memories about growing up in your homes and discussing the chores that were part of your lives.

I Don’t Want to Fight

As the quiet afternoon segues into early evening, you may notice that Sally experiences increased periods of disorganized thinking, agitation, wandering, and changes in verbal behavior. These adverse behaviors, known as “sundowning,” are associated with changes in lighting in specific areas of Sally’s living space. As the sun goes down, her environment becomes darker, and shadows form that are unfamiliar and frightening. To alleviate Sally’s fears, consider increasing the lighting in her living space, reducing background noise from the television or outside, and play her favorite music.

Changes in daylight are not the only cause of behavioral changes. Adverse behaviors often stem from an unmet need.

If Sally is wandering, she may be searching for a restroom or the kitchen for a snack.
If she is angry or rummaging, she may be looking for a sweater to keep warm.
If she is sad, she may need a friend to hold her hand, hug her, or hear the voice of a loved one over the phone.
If she is shouting or curled up in a chair, she may be overstimulated and require a change of scenery. Lead her by the hand to a quiet area and offer her something soothing to hold, such as a blanket, a plush object, or a favorite pillow, along with a favorite beverage or snack.
If she is fatigued, it is time for a night’s rest. Taking her by the hand, lead her to her favorite “comfy” chair or bed, cover her with a warm blanket sprinkled with a drop or two of essential oils for relaxation, leave a night light on, and watch her drift into a restful sleep.

I Feel Like You Know Me

Caregivers can establish strong connections with individuals like Sally by employing effective communication strategies and reminiscence techniques. By recognizing and honoring the richness of each care receiver’s life, caregivers can shift their perspective from seeing the “old lady” in room 306 with her many challenges, stemming from physical limitations and behavior issues, and begin to focus on caring for the person in 306, who has a name, Sally. When caregivers acknowledge their care receivers by name, they recognize that everyone has stories to share. These stories foster deeper, more meaningful interactions. It is essential to value each person’s unique experiences and wisdom, creating an environment where they feel seen and respected. By engaging in this compassionate practice, caregivers enhance the well-being of those in their care and celebrate the vibrant lives they have led, thereby reinforcing their identity as cherished individuals who deserve recognition and understanding.