When caring for a person with dementia, you may have noticed that conversations can become a struggle as the condition progresses.

While it can be a challenge, it’s important not to lose your patience as this will make things more strained between you. Even if you’re feeling tired or mentally drained, always strive to be courteous and respectful, as the person will pick up on your mood or tone, even if they don’t fully understand what you are saying. When you speak to the person, talk to them at the same physical level. This may mean kneeling down so you’re at eye level with them. Get rid of obstacles like a table that may be in the way, when you talk. When they are talking, look at their face and make eye contact. Concentrate on what they are saying. At the same time, respect their personal space by not getting too close to them.

If you are asking them a question, keep it simple. Break the question down into shorter chunks. Don’t ask them a question on top of another question. Avoid conversations like: ‘What would you like for lunch? We’ve got fish, chicken, cheese, or would you like me to see if there’s anything else? What did you fancy?’ Instead, keep questions short and concise, or break them down. Try this:

‘Would you like some lunch?’

‘Would you like me to tell you what you’ve got in the fridge?’


‘Would you like me to make you a sandwich?’

Make instructions clear and slow, and let them come back to you with questions.

Non-verbal communication
When verbal communication is no longer good, it’s still important to try and keep the person stimulated. Finding a common link or identifying their past interests may help.

Signs of distress
If you feel the person you are caring for is behaving in an unreasonable manner, or they are restless, emotional, shouting or they seem depressed, it could be that one of these above needs is not being met. It’s also important to rule out any medical issues or changes – a urinary tract infection can have a significant effect on a person’s behaviour, so if their mood changes suddenly, it’s important for them to see their GP immediately, to rule out or treat an infection. They might also be depressed, so always seek medical help in the event of any sudden or significant changes.

It could also be that they are in pain. Watch for changes in how they walk or move, and see if they are holding their stomach or head. Ask them if they are in pain and see if they can point to where the pain is. They may also be constipated, or need to use the toilet, but be unable to communicate this to you.

Maintaining a person’s self-esteem is about treating them as an adult and not a child. Even if the person is virtually entirely dependent on you, treat them like an adult and show respect. Don’t tell them what they can’t do anymore – make it about what they can do for themselves.

If they say something that’s factually incorrect, don’t correct them as this will only cause friction. There’s nothing to be gained by pointing out their mistake. Don’t challenge or contradict what they say. Try to keep the harmony.