Gradual Changes in Communication

The gradual loss of the ability to communicate in a person with dementia creates difficulties both for the individual and their environment. The person struggles to communicate, often does not understand what others say, and cannot fully express their own feelings, resulting in increasing difficulty and withdrawal.

The progression of the disease also causes significant communication challenges for those close to the person. Caregivers, often family members, face the same difficulties: unsuccessful communication and frequent misunderstandings due to the gradual decline in communication ability characteristic of dementia, leaving everyone feeling helpless and misunderstood.

Each person with dementia is unique, as are the challenges they face in expressing their thoughts and feelings. There are many causes of dementia, each affecting the brain differently. Some changes you may observe in a person with dementia include:

• Difficulty finding words.

• Speaking fluently but producing sentences that don’t make sense.

• Partial or no understanding of what is being said.

• Decline in reading and writing abilities.

• Loss of usual social behaviors in conversations, such as interrupting, ignoring the speaker, or not responding.

• Difficulty expressing emotions appropriately.

Remember:

Communication involves expression of feelings and behavior and consists of three parts:

• 55% body language (facial expressions, posture, gestures)

• 38% tone and volume of voice

• 7% words used

This explains how families and caregivers appear to a person with dementia. Negative body language, such as sighs or raised eyebrows, can be easily recognized by the person with dementia.

For an easier and smoother daily life, you can try:

• Establish routines while maintaining familiar procedures: daily life can be confusing for people with dementia; routines bring order and reduce daily decisions.

• Support the person’s independence to preserve self-respect. Do not talk as if they aren’t present when discussing their condition with others.

• Use activities like gardening to engage them.

• Avoid arguments as they cause unnecessary stress for both sides. Do not focus on failures—the disease is responsible, not the person.

• Maintain a sense of humor and laugh together. Humor relieves anxiety for both the person with dementia and the caregiver.

• Prioritize safety. Loss of coordination and memory increases risks of injury (e.g., hot water, loose rugs, cables).

• Encourage physical exercise and health to maintain existing physical and mental abilities.

• Help the person benefit from skills they still have. Include familiar activities related to their past profession or hobbies to boost satisfaction and self-esteem. Participation may decline over time.

Maintain communication by:

• Ensuring the person’s senses, such as sight and hearing, are functioning well (e.g., proper glasses, working hearing aids).

• Speaking clearly, slowly, face-to-face, and at eye level.

• Showing love and warmth through your care if it does not upset the person.

• Paying attention to their body language—people with limited speech communicate non-verbally.

• Being mindful of your own body language.

• Using reminder words and prompts that help you communicate effectively.

• Gaining their attention before speaking.

Compassionate Approach

People with dementia retain emotions even if they don’t understand what is said, so always protect their dignity and self-respect.

Be patient and allow enough time for responses. When appropriate, touch the person gently to maintain attention and express warmth and empathy.

Ways of Speaking

• Stay calm and speak softly and sincerely.

• Use short, simple sentences focusing on one topic at a time.

• Give ample time for them to understand.

• Use identifying names where possible, e.g., “your son, John.”

Physical Communication

• Use gestures and facial expressions to aid understanding.

• Showing rather than telling can help.

• Holding hands and gentle touch maintain attention and show care.

• Warm smiles and shared laughter are often better understood than words.

Creating the Right Environment

• Minimize background noise (TV, radio).

• Stay still while speaking to help the person focus, especially if they can see you.

• Keeping a regular routine reduces confusion and improves communication.

• Consistent approaches by all family and caregivers reduce confusion. Repeat messages in the same way.

What NOT to Do

• Do not argue with the person—it worsens the situation.

• Avoid giving constant commands.

• Don’t focus on what they cannot do; suggest what they can do instead.

• Avoid patronizing tones, which are perceived even if words are not understood.

• Don’t ask many questions relying on good memory.

• Don’t speak about the person as if they’re not there.

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Care for the Caregiver

Family

Family is usually the greatest support and help for a Greek dementia patient, but can also be a source of pressure due to lack of knowledge. Often, one relative takes on caregiving and faces pressure from other family members. A family meeting can help everyone understand the disease and discuss care plans.

As the disease progresses, care needs increase—from little care during early stages when the patient is mostly independent, to much more in later stages involving help with toileting, bathing, swallowing, and eating. Caring for a dementia patient 24/7 is humanly impossible.

Caregiver well-being is crucial. Caregivers may initially underestimate the demands and want to do everything alone. Either the caregiver or a close person should encourage attention to the caregiver’s own health:

• Talk about your concerns: Share feelings about caregiving. Don’t isolate yourself—acknowledging emotions helps coping. Accept support from others.

• Find time for yourself: Socialize, enjoy hobbies, have fun. It’s vital for your well-being.

• Know your limits: Recognize your endurance before exhaustion. Protect yourself from burnout.

• Seek and accept advice: Don’t blame yourself or the person with dementia for problems—the disease is the cause. If relationships with relatives or friends suffer, identify causes and discuss them. Social support benefits both patient and caregiver.

• Don’t blame yourself: Dementia progresses continuously, and care needs change accordingly. Seek advice on your changing role and the patient’s condition.

• Remember you are important: Without the caregiver, the patient couldn’t manage. Caregivers must care for themselves.

• Accept help from friends and family: They may want to help but not know how—guide them.

• Use medical support: Doctors, nurses, and professionals can assist with:

  • Diagnosis and patient monitoring.

  • Practical care needs like medical beds, oxygen, depending on patient condition.

  • Respite care by professionals who can provide intermittent or full-time care when needed.

  • Regular health checks.

  • Home nursing care if necessary.

  • Information and advice for better disease management.

All these services are included in our Specialized Home Care Programs offered by our agency.