How to Communicate with a Parent Who Has Dementia

One of the most heartbreaking aspects of watching a parent develop dementia is the gradual loss of the easy communication you once shared. Conversations that used to flow naturally now become filled with confusion, repetition, and sometimes frustration on both sides.

But here's something important to understand: communication with someone who has dementia is still possible. It just requires a different approach. The goal shifts from exchanging information to connecting emotionally, from correcting facts to validating feelings.

This guide will help you develop communication strategies that work at each stage of dementia, reduce frustration for both of you, and help you maintain the deepest possible connection with your parent.

Understanding How Dementia Affects Communication

To communicate effectively, it helps to understand what's happening in your parent's brain.

Language Changes in Dementia

• Word-finding difficulties: They know what they want to say but can't find the right words
• Substituting words: Using related but incorrect words ("chair" for "table")
• Made-up words: Creating new words when they can't find the real one
• Losing train of thought: Starting sentences and forgetting where they were going
• Difficulty following conversations: Especially with multiple speakers or topic changes
• Trouble understanding complex sentences: Long or complicated statements become confusing

Comprehension Changes

• Processing slows: They need more time to understand what you've said
• Abstract concepts become difficult: Concrete, specific language works better
• Questions are confusing: Especially open-ended or multi-part questions
• Sarcasm and idioms are lost: They may take figurative language literally

What Still Works

• Emotional memory: They may not remember what you said, but they'll remember how you made them feel
• Long-term memories: Often preserved longer than recent memories
• Nonverbal communication: Touch, facial expressions, and tone of voice remain meaningful
• Music and rhythm: Song lyrics and musical memories often persist
• Procedural memory: Skills learned long ago may remain

Core Communication Principles

These principles apply throughout all stages of dementia and form the foundation of effective communication.

1. Don't Argue or Correct

This may be the hardest but most important principle. When your parent says something factually wrong, your instinct is to correct them. Resist it.

Why correcting doesn't work:

• It won't help them remember correctly
• It causes frustration and often triggers arguments
• It makes them feel incompetent or attacked
• It damages the emotional connection you're trying to maintain

Instead of correcting:

• Validate their feelings
• Redirect to a different topic
• Go along with their reality when safe to do so
• Focus on the emotional truth behind what they're saying

2. Enter Their Reality

Your parent may believe they need to go to work, that their deceased mother is coming to visit, or that it's 1965. Rather than pulling them into your reality (which causes distress), enter theirs.

Example:

Parent: "I need to go to work! I'll be late!"

Instead of: "Mom, you retired 20 years ago."

Try: "What do you need to do at work today?" or "Your boss called and said you have the day off."

3. Focus on Feelings, Not Facts

Pay attention to the emotion behind what they're saying rather than the literal words.

Example:

Parent: "My mother hasn't visited in so long."

Feeling: Loneliness, missing their mother

Response: "You really love your mother. Tell me about her." (Not: "Mom, grandma died in 1987.")

4. Keep It Simple

• Use short, simple sentences
• One idea at a time
• Yes/no questions instead of open-ended ones
• Concrete rather than abstract language
• Speak slowly and clearly
• Allow time for processing

5. Use Nonverbal Communication

As verbal communication becomes harder, nonverbal becomes more important:

• Eye contact: Get on their level, face them directly
• Touch: Hold hands, gentle touches on arm or shoulder
• Facial expressions: Smile, show warmth
• Tone of voice: Calm, warm, reassuring (they hear how you say it even when they don't understand what you say)
• Body language: Open, relaxed posture

Practical Communication Strategies

Before Speaking

1. Get their attention first: Say their name, make eye contact
2. Approach from the front: Don't startle them from behind
3. Reduce distractions: Turn off TV, move to quiet area
4. Be at eye level: Sit if they're sitting
5. Check for glasses and hearing aids: Make sure they can see and hear you

How to Ask Questions

Instead of: "What would you like for lunch?"

Try: "Would you like soup or a sandwich?"

Instead of: "What did you do today?"

Try: "I see you were looking at photos. Who is this?"

Instead of: "Don't you remember?"

Try: "Let me tell you about that..."

Handling Repetitive Questions

Your parent asking the same question repeatedly is frustrating, but understanding why helps:

• They genuinely don't remember asking before
• The question often reflects underlying anxiety
• They may need reassurance, not information

Strategies:

• Answer calmly each time: It's new to them each time
• Address the emotion: "You seem worried about that. Everything is okay."
• Redirect: After answering, change the subject
• Written reminders: "Dinner is at 6" on a whiteboard can help
• Reassurance objects: Photo of family member, familiar object

When They Don't Recognize You

This is devastating, but it doesn't mean they don't love you. Their memory of your current appearance has faded, but often they remember you from earlier in life.

Strategies:

• Don't insist: "Don't you know who I am?" causes distress
• Introduce yourself casually: "It's Sarah, your daughter"
• Focus on connection, not recognition
• Show photos from when you were younger
• Accept that they may think you're a younger version of yourself or someone else

Therapeutic Fibbing

Sometimes a small therapeutic fib prevents significant distress.

Example:

Parent: "Where's my husband?" (Husband died years ago)

Telling the truth might cause them to experience the grief as if it just happened, repeatedly.

A therapeutic fib: "He stepped out for a bit" or "He's doing fine" can provide comfort.

Guidelines for therapeutic fibbing:

• Use it to reduce distress, not for your convenience
• Match their emotional reality
• Redirect after the fib
• It's not the same as lying for personal gain

Communication by Stage

Early Stage

Your parent is still largely communicative but may have word-finding issues and repeat questions.

• Give them time to find words; don't finish sentences unless they want help
• Have important conversations earlier in the day when they're less tired
• Involve them in decisions while they're still able
• Be patient with repetition; don't point it out
• Use humor gently; they may still appreciate it

Middle Stage

Communication becomes more challenging. They may not recognize family or understand complex conversations.

• Simplify everything: short sentences, simple words
• Use visual cues and gestures along with words
• Focus more on emotional connection than information exchange
• Accept that they may confuse time periods, people, and places
• Redirect rather than correct
• Use activities (looking at photos, folding laundry) as conversation starters

Late Stage

Verbal communication may be minimal or absent, but connection is still possible.

• Focus almost entirely on nonverbal communication
• Touch, music, and presence matter most
• Speak calmly even if they can't respond; they may understand more than they can express
• Watch for nonverbal signs of comfort or distress
• Simple sensory experiences: holding hands, gentle touch, favorite music

Handling Difficult Situations

Agitation and Anger

When your parent becomes agitated:

• Stay calm: Your anxiety increases theirs
• Speak softly: Raised voices escalate the situation
• Don't argue: Even if they're saying hurtful things
• Look for the cause: Pain, hunger, need for bathroom, overstimulation?
• Redirect: Change the subject or environment
• Give space if safe: Sometimes walking away briefly helps

Accusations and Paranoia

Common accusations include theft, infidelity, or being held prisoner.

• Don't take it personally; it's the disease
• Don't argue or provide evidence against their belief
• Validate the feeling: "That sounds really upsetting"
• Help "look" for the "stolen" item if appropriate
• Redirect to another activity

Refusal of Care

When they refuse bathing, medications, or eating:

• Try later: Their mood may be different in an hour
• Break it down: One step at a time rather than announcing the whole task
• Make it their idea: "Should we get cleaned up before visitors come?"
• Offer choices: "Do you want the blue shirt or the green one?"
• Adjust expectations: Maybe full bath isn't needed today

When You Feel Frustrated

It's normal to feel frustrated. Here's how to manage:

• Take a breath before responding
• Remember: it's the disease, not your parent being difficult
• Take breaks when you can
• Lower your expectations for the conversation
• Seek support from other caregivers who understand
• Forgive yourself for imperfect moments

Maintaining Meaningful Connection

Beyond practical communication, focus on maintaining emotional connection.

Activities That Promote Connection

• Music: Sing old songs, play their favorite music
• Photos: Look at old photos together
• Touch: Hand massage, brushing hair, holding hands
• Nature: Sitting outside, watching birds
• Pets: Interaction with animals (real or robotic companions)
• Simple tasks: Folding towels, sorting items
• Familiar rituals: Morning coffee together, saying grace

Making Visits Meaningful

• Focus on quality of time, not duration
• Bring something to do together
• Keep visits calm and low-stimulation
• Don't quiz them on names or memories
• Leave on a positive note

Frequently Asked Questions

Final Thoughts

Communicating with a parent who has dementia requires a fundamental shift in approach. You're not trying to win arguments, convey information, or maintain the relationship you used to have. You're meeting your parent where they are and connecting with them in whatever way is still possible.

Some days will be harder than others. You'll make mistakes, lose patience, and feel grief for the parent you're losing. That's normal. What matters is continuing to show up, continuing to try, and remembering that underneath the confusion, your parent is still there, still capable of feeling loved and connected.

The gift you give by learning these communication strategies isn't just for your parent. It's for you too, allowing you to have as much connection as possible during this difficult journey.