9 Tips for Speaking to Someone Who Has Alzheimer’s Disease

When a loved one is in the throes of cognitive decline, it can be difficult to predict what each day will bring. Alzheimer’s is a progressive disease, gradually affecting a person’s ability to communicate over time. And as difficult as it may be, it is imperative to keep the lines of communication open and to help our loved ones maintain their connection to the world around them. It is important to remember that effective communication with Alzheimer’s patients will require some preparation and patience.

Very often, when we are in the company of someone with Alzheimer’s, we tend to speak directly to their companion, aide, or another family member. However, it is important that we don’t exclude the person with the disease from the conversation. Ruth Drew, Director of Information and Support Services at the Alzheimer’s Association, urges us to treat our loved ones in cognitive decline “with the respect that a lifetime of experience on this earth deserves.”

Alzheimer’s unfolds in stages, and very often, what worked today won’t work tomorrow, and effective communication can feel like a moving target. The following tips can help caregivers, family, and friends communicate more effectively with those in cognitive decline.


Avoid distractions

Choose a time and place where background noise and distractions are limited.

Make sure you have their attention

Address your loved one by their name and gently identify yourself and your relationship in a way that will not embarrass them. For example, you might say, “You have always been one of my favorite aunts, and I loved growing up near you in New York” as opposed to “I am your niece. Remember?!”

Maintain eye contact

Position yourself in a way that allows you to maintain eye contact with your loved one. Try to sit at an even level or slightly below the person. This simple act shows them that what they are saying is important to you, and it alleviates feelings of intimidation or inferiority.

Avoid asking open-ended questions

When faced with open-ended questions, your loved one may struggle to find the right words. This can lead to frustration, and from there, the conversation will quickly deteriorate. Instead of asking open-ended questions, provide two options or stick to questions that only require a yes or no reply. Instead of asking, “What would you like to eat?” try, “Would you like a sandwich?” or “Would you like a sandwich or soup?”

Give the person plenty of time to respond

Your loved one may struggle with word recall, making it quite difficult to say what they need to say. While it is okay to make suggestions, do not interrupt or rush the response. If you find they are getting frustrated, offer reassurance. Consider the feelings behind the words and feel free to repeat their words for clarity.

Do not argue, criticize, or correct

Over time, Alzheimer’s disease tends to blur the lines of reality. This can lead to confusion and possibly even your loved one insisting on stories or things that never happened. In this case, do not try to convince them that they are mistaken. If they say something you do not agree with, let it be and don’t address their delusions, or correct their misremembering and repetition. Remember that even if they ask you the same question 10 times, it may always feel like the first time for them.

Use nonverbal cues

If verbal communication is too difficult or no longer an option, use alternative ways to communicate such as touch, sights, sounds, smells, and tastes. Relying on gestures or visual cues can be effective communication strategies when trying to connect with someone who has Alzheimer’s disease. While your loved one may not remember the conversation, they will remember the way you made them feel afterward.

Maintain a sense of humor

As in all communication, humor can work wonders to lighten the mood and bring you and your loved one closer together.

Bring them back to the good old days

As short-term memory fades, long-term memory sharpens. Chances are, your loved one may not remember what happened 40 minutes ago, but they will be able to recall their lives 40 years ago. Try asking general questions about the past. Choose something they would remember fondly, like their childhood, wedding, or military service. Reminiscing about such memories can make them feel happy and engaged, and the stories they share now have an opportunity to live on.

For caregivers, Alzheimer’s disease has a heavy learning curve. Grasping the nuances of effective communication with Alzheimer’s patients will not happen overnight. It’s okay if you run out of things to say. What matters most is that you try your best. Sometimes, your loving presence or gentle touch is more than enough.