5. Communicating with someone with dementia

When you have a ‘what matters’ conversation with someone with dementia, it can take longer for them to understand what you’re saying or what’s going on.

So, it’s important to:

• ask open questions that focus on one topic at a time
• allow space for silence to let the person catch up on the topic and answer.

People may also talk around a word, describing it. For example, ‘watch’ may be ‘time’. Allow people time to describe.

People with dementia often remember non-verbal communications and the way a discussion made them feel, even if they can’t remember the specifics. You could use tools to help facilitate the conversation, such as:

• pictures
• key words on pieces of paper
• ‘talking mats’.

If the person has a learning disability and dementia, you may need to choose different communication tools.

It's important to understand that any challenge lies in the communication process, not with the person with dementia.

It’s helpful for you to know the person’s preferred language before the conversation.

If their preferred language is different to yours, it may be helpful to include someone who can translate into their first or preferred language. They may be able to express themselves better in their first language.

If someone can’t communicate verbally, they may be able to:

• communicate through Makaton or other sign languages
• use their own methods of non-verbal communication, such as pointing, shaking their head (to say yes or no), facial expressions, or body language
• use symbols to convey their thoughts
• express their feelings through actions or responses.

Non-verbal cues, such as facial expressions, body language, and gestures, are essential for understanding the needs and feelings of people living with dementia.

We can use these cues to focus on creating a supportive and inclusive environment, respecting the person's needs and preferences at all times.

Remember, your role is to find effective ways to communicate. Sometimes, actions or responses are the only way people feel they can express themselves.

If you’re supporting someone who uses non-verbal methods, you may need to pay more attention to the views and thoughts of people who know them well.

There may be people who have known the person for many years, and their insights will usually be very useful. Sometimes these people are called a ‘circle of support’.

For individuals with dementia, communication needs can be different.

If someone uses BSL, they may use older signs that might be unfamiliar to modern interpreters.

It's important to consider this when supporting someone with dementia who uses BSL. You can find out more about this in our guide: Good Work framework: working with people living with dementia who have hearing loss, or use British Sign Language.

You may also need to consider the person’s capacity. This means their ability to understand information and make decisions about their life. Considering mental capacity is an important way to make sure the person’s voice is heard.

Assume capacity

Always start with the assumption that the person has capacity unless proven otherwise. This respects their autonomy and rights.

Look for previous assessments

Before you make any decisions, look for any previous assessments that may have been done. This can provide valuable insights into the person’s abilities and needs.

Make the most of their capacity

Think about how you can make the most of any capacity the person does have, no matter how little that may be. This might involve using simpler language, visual aids, or other communication methods.

Legal framework

You can find out more about the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) on our website.