What communication strategies work well when working with a client with dementia?

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Use calm, positive body language to talk to someone with dementia
What are nonverbal dementia communication techniques?
6 nonverbal dementia communication techniques

Use calm, positive body language to talk to someone with dementia

Communicating with someone with Alzheimer’s or dementia can be made easier with some new techniques.

The damage in their brain has changed the way your older adult hears, processes, and responds to conversation.

That’s why it’s necessary to adapt the way we communicate to match their abilities.

Often, the nonverbal messages we send with our body language and facial expressions come through more clearly than the words we speak.

And sometimes, the nonverbal messages don’t match the words we use, which causes confusion.

But when we use body language and facial expressions that help seniors clearly and easily understand our meaning, it reduces confusion, agitation, and anger and also increases cooperation.

Using these nonverbal communication techniques to talk to someone with dementia makes caregiving easier and improves quality of life for both of you.

We explain what nonverbal communication is and share 6 helpful tips that you can use right away.

What are nonverbal dementia communication techniques?

There are many different types of nonverbal communication, including:

1. Facial expressions
Your face can express emotions without saying a word. And many facial expressions are the same across cultures, like happiness, sadness, anger, surprise, fear, and disgust.

2. Body movements and posture
The way someone moves and carries themselves can say a lot about them, their mood, and their state of mind.

3. Gestures
When we talk, we use gestures without even thinking about it – waving, pointing, and using our hands when we’re angry or excited.

4. Eye contact
For people who can see, vision is the dominant sense. That’s why eye contact is so important.

The way you look at someone can say a lot. Plus, eye contact helps you see the other person’s engagement level and reactions.

5. Touch
Touch is another way to “speak” without using words.

For example, these mean very different things: a limp handshake, a gentle shoulder tap, a warm hug, a reassuring pat on the back, a patronizing pat on the head, or a controlling grip on the arm.

6. Space
Everyone needs some physical space, though how much may vary for each person and situation.

For example, standing too close can make someone uncomfortable. But staying at too far a distance could seem uncaring or uninterested.

7. Voice
The tone and volume of your voice adds a lot of meaning to words.

For example, imagine saying “fine” during a heated argument compared to saying it when you’re happy and content. The same word sounds completely different.

6 nonverbal dementia communication techniques

1. Be patient and calm

Project a positive and calm attitude – it can help your older adult communicate more easily
Avoid body language that shows frustration, anger, or impatience
Try not to interrupt them
Give them your full attention

When a situation is very frustrating, staying calm can be tough.

In those cases, it’s worthwhile to step away for a minute to do some deep breathing or calming exercises so you can come back with a calm attitude.

That helps you avoid a situation where your tension or frustration could subconsciously influence your older adult’s responses or behavior.
2. Keep voice, face, and body relaxed and positive

Have a pleasant or happy look on your face – a tense facial expression could cause distress and make communication more difficult

Keep your tone of voice positive and friendly

3. Be consistent
Avoid confusion by making sure your body language and facial expressions match the words you’re speaking.

4. Make eye contact and respect personal space

Approach from the front so they can see you coming and have a chance to process who you are and the fact that you’re going to interact with them
Don’t stand too close or stand over them – it can feel intimidating
Keep your face at or below their eye level, this helps them feel more in control of the situation
Make and maintain eye contact while having a conversation

5. Use gentle touch to reassure
Physical touch can give comfort and reassurance, but be sure to observe to make sure they’re comfortable with the touching.

This could include:

Shaking hands
Patting or holding their hand
Patting or rubbing their shoulder or back
Putting an arm around them
Giving a hug

6. Observe their nonverbal reactions
Dementia may make it difficult for your older adult to express themselves verbally.

Watch for signs of frustration, anger, or fear and adjust your responses and actions to calm or soothe as needed.

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By DailyCaring Editorial Team

Dementia is a progressive illness that, over time, will affect a person's ability to remember and understand basic everyday facts, such as names, dates and places.

Dementia will gradually affect the way a person communicates. Their ability to present rational ideas and to reason clearly will change.

If you are looking after a person with dementia, you may find that as the illness progresses you'll have to start discussions to get the person to make conversation. This is common. Their ability to process information gets progressively weaker and their responses can become delayed.

Try to start conversations with the person you're looking after, especially if you notice that they're starting fewer conversations themselves. It can help to:

speak clearly and slowly, using short sentences
make eye contact with the person when they're talking or asking questions
give them time to respond, because they may feel pressured if you try to speed up their answers
encourage them to join in conversations with others, where possible
let them speak for themselves during discussions about their welfare or health issues
try not to patronise them, or ridicule what they say
acknowledge what they have said, even if they do not answer your question, or what they say seems out of context – show that you've heard them and encourage them to say more about their answer
give them simple choices – avoid creating complicated choices or options for them
use other ways to communicate – such as rephrasing questions because they cannot answer in the way they used to

The Alzheimer's Society has lots of information that can help, including details on the progression of dementia and communicating.

Communication is not just talking. Gestures, movement and facial expressions can all convey meaning or help you get a message across. Body language and physical contact become significant when speech is difficult for a person with dementia.

When someone has difficulty speaking or understanding, try to:

be patient and remain calm, which can help the person communicate more easily
keep your tone of voice positive and friendly, where possible
talk to them at a respectful distance to avoid intimidating them – being at the same level or lower than they are (for example, if they are sitting) can also help
pat or hold the person's hand while talking to them to help reassure them and make you feel closer – watch their body language and listen to what they say to see whether they're comfortable with you doing this

It's important that you encourage the person to communicate what they want, however they can. Remember, we all find it frustrating when we cannot communicate effectively, or are misunderstood.

Communication is a two-way process. As a carer of someone with dementia, you will probably have to learn to listen more carefully.

You may need to be more aware of non-verbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking.

Active listening can help:

use eye contact to look at the person, and encourage them to look at you when either of you are talking
try not to interrupt them, even if you think you know what they're saying
stop what you're doing so you can give the person your full attention while they speak
minimise distractions that may get in the way of communication, such as the television or the radio playing too loudly, but always check if it's OK to do so
repeat what you heard back to the person and ask if it's accurate, or ask them to repeat what they said

Page last reviewed: 9 January 2020
Next review due: 9 January 2023