How to Identify Non Verbal Signs of Pain in Dementia and Communicate Effectively

SYNERGY HomeCare | Effective communication with a loved one

Alzheimer’s Disease and other dementias gradually diminish a person’s ability to communicate. According to the Alzheimer’s Association, communication with a person with Alzheimer’s requires patience, understanding and good listening skills.

Using a person-centered approach can be very effective. Person-centered care emphasizes the individual’s unique needs, personal experiences and strengths rather than focusing on their declining or lost abilities. This philosophy not only values and respects the individual with dementia but also promotes well-being and health by ensuring that every experience and interaction is seen as an opportunity to have authentic and meaningful engagement. This, in turn, helps create a better quality of life for the person living with dementia.

The communication strategies below can help both you and the person living with dementia understand each other better.

Communication in Early Stage Dementia

People in the early stage of Alzheimer’s Disease are still able to participate in meaningful conversation and engage in social activities. However, he or she may repeat stories, feel overwhelmed by excessive stimulation or have difficulty finding the right word. Tips for successful communication:

  • Don’t make assumptions about a person’s ability to communicate because of an Alzheimer’s diagnosis. The disease affects each person differently.
  • Discuss which method of communication – face to face, phone calls or email – is preferable.
  • Make sure to include the person living with dementia in conversations.
  • Address the person directly, rather than to a caregiver or companion.
  • Give the person plenty of time to respond. Don’t interrupt unless help is requested.
  • Take time to listen to the person express his or her thoughts, feelings and needs.
  • It’s OK to laugh. Sometimes humor lightens the mood and makes communication easier.
  • Ask what activities the person is still comfortable doing and what he or she may need help with.
  • Maintain your connection; your friendship, understanding and support are more important to the person than ever.

Communication in Middle Stage Dementia

The middle stage of Alzheimer’s is typically the longest and can last for many years. As the disease progresses, the person will have greater difficulty communicating and will require more direct care. Tips for successful communication include:

  • Engage the person in one-on-one conversation in a quiet space that has minimal distractions.
  • Speak slowly and clearly.
  • Make and keep eye contact. It shows you care about what he or she is saying.
  • Be sure to allow plenty of time for the person to respond.
  • Offer reassurance and encourage the person to explain his or her thoughts.
  • Ask one question at a time.
  • Use yes or no questions. For example, “Would you like some coffee?” rather than “What would you like to drink?”
  • Avoid criticizing or correcting. Instead, listen and try to find the meaning in what the person says. Repeat what was said to clarify.
  • Try not to argue. If the person says something you don’t agree with, let it be. 
  • Simplify instructions for tasks. Lengthy requests may be overwhelming.
  • Give visual cues. Demonstrate a task to encourage participation.
  • Write notes when spoken words seem confusing.

Communication in Late Stage Dementia

The late stage of Alzheimer’s disease may last from several weeks to several years. As the disease advances, the person with Alzheimer’s may rely on nonverbal communication, such as facial expressions or vocal sounds. Around-the-clock care is usually required in this stage. Tips for successful communication:

  • Approach the person from the front and identify yourself.
  • Encourage nonverbal communication. If you don’t understand what the person is trying to say, ask him or her to point or gesture.
  • Use touch, sights, sounds, smells and tastes as a form of communication with the person.
  • Consider the feelings behind words or sounds. Sometimes the emotions being expressed are more important than what’s being said.
  • Treat the person with dignity and respect. Avoid talking down to the person or as if he or she isn’t there.
  • It’s OK if you don’t know what to say; your presence and friendship are most important.

At every stage of Alzheimer’s Disease, effective communication can go a long way in providing a person with unwavering emotional support and a deeply comforting sense of security.

For more information on caring for a loved one with dementia, download SYNERGY HomeCare’s free Memory Care Guide.

SYNERGY HomeCare offers no obligation home assessments. Find a location near you or Contact us to talk to a Memory Care specialist.

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