Communicating with a Parent Who Has Dementia

Dementia changes how your parent processes information, forms memories, and uses language. The communication techniques that worked your whole life—logic, explanations, reminders—often don't work anymore. This isn't their fault, and it's not yours either.

Learning new ways to communicate can reduce frustration for both of you and help you maintain connection even as the disease progresses.

General Communication Principles

How to Speak

• Use simple sentences: One idea at a time
• Speak slowly and clearly: But not condescendingly
• Use a calm, warm tone: They read tone even when words confuse them
• Make eye contact: Get their attention before speaking
• Use their name: Helps focus attention
• Avoid pronouns: Say "Mom" instead of "she"
• Give one instruction at a time: Break tasks into steps
• Allow time: Wait for response—don't rush them

What to Avoid

• Don't correct or argue: "You're wrong" creates conflict, not understanding
• Don't quiz or test: "Do you remember who I am?" is frustrating and embarrassing
• Don't use logic: "You already ate" won't override their feeling of hunger
• Don't talk about them in front of them: They often understand more than they can express
• Don't raise your voice: Louder doesn't help; clearer does
• Don't use sarcasm or idioms: They may take things literally

Responding to Repetitive Questions

Your parent may ask the same question dozens of times. This is one of the hardest aspects of dementia care.

Why It Happens

• They genuinely don't remember asking
• They're anxious and seeking reassurance
• They're trying to hold onto something that feels important
• The question may represent an unmet need

How to Respond

• Answer as if it's the first time: Your irritation shows; their confusion remains
• Address the underlying need: "What time is dinner?" may mean "I'm hungry" or "I'm anxious"
• Redirect: Answer briefly, then change the subject
• Write it down: Sometimes a visible note provides reassurance
• Use visual cues: Clock, calendar, whiteboard with daily schedule

When They Don't Recognize You

One of the most painful parts of dementia is when your parent doesn't know who you are. This usually happens in later stages.

What's Happening

• Their image of you may be frozen at a younger age
• They may confuse you with someone from their past
• They may know you're familiar but can't place you
• Emotional recognition often outlasts name recognition

How to Respond

• Don't force it: "I'm your daughter!" often causes distress
• Gently identify yourself: "It's Sarah. I'm here to visit you"
• Focus on connection, not recognition: If they think you're a nice visitor, be a nice visitor
• Use photos: Looking at old photos together may help
• Protect yourself: This is grief. Your feelings matter too

Therapeutic Fibbing

Sometimes the most compassionate response involves entering their reality rather than insisting on factual truth.

When It May Be Appropriate

• They ask about a deceased spouse or parent
• They want to "go home" (to a childhood home that no longer exists)
• They're worried about going to a job they retired from decades ago
• The truth would cause distress without any benefit

Examples

• "Where's my mother?" → "Tell me about your mother. What was she like?"
• "I need to get to work." → "It's your day off. What would you like to do?"
• "I want to go home." → "What do you miss about home? Let's look at some photos."

Communication Beyond Words

As verbal communication becomes more difficult, other forms of connection become more important:

Non-Verbal Connection

• Touch: Holding hands, gentle back rubs, hugs (if welcomed)
• Eye contact: Looking at them when you speak
• Presence: Just sitting together quietly
• Facial expressions: Smile, look calm and warm
• Body language: Sit at their level, face them, appear relaxed

Music and Sensory Connection

• Play familiar music: Songs from their youth often remain accessible
• Sing together: Lyrics may be remembered when other words are lost
• Look at photos together: Old photos can spark memories
• Engage senses: Familiar smells, textures, tastes

Managing Difficult Behaviors Through Communication

Agitation and Anger

• Stay calm—your agitation escalates theirs
• Speak softly and slowly
• Don't argue or try to explain
• Acknowledge their feelings: "You seem upset. I'm sorry this is hard"
• Try to identify the trigger (pain, overstimulation, need)
• Redirect to a calming activity

Paranoia and Accusations

• Don't defend yourself or argue—it doesn't help
• Respond to the feeling: "That sounds scary"
• Help them feel safe
• Check whether something real prompted the fear (lost item, confusing situation)
• Redirect to something comforting

Refusing Care

• Don't demand or force
• Try again later
• Offer choices: "Would you like to take a bath or just wash up?"
• Make it matter-of-fact: "It's time to get ready for dinner"
• Use distraction: start a conversation while doing the task

Taking Care of Yourself

Communication challenges are emotionally exhausting. Remember:

• You will lose patience. That's human, not failure
• Step away when you need to—even briefly
• The person you knew is still in there, even if they can't show it
• Find support from others who understand
• Grieve the losses as they happen—don't wait until the end