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How to Speak with Someone Who is Confused

Communication Tips for Caregivers of People with Dementia

Communication is often challenging when caring for someone who is confused. The caregiver may meet with resistance when trying to provide personal care such as bathing or feeding. The person who is confused may ask about someone who died years ago, say the same things over and over, or may not be able to speak at all. These basic tips may help caregivers to anticipate and avoid common communication pitfalls when caring for someone with dementia.

Focus on Abilities of the Person with Dementia

People with dementia such as Alzheimer’s tend to lose short-term memories first while experiencing a gradual decline in long-term memories. This can be frightening, depressing, and challenging for the person and the caregiver. Focusing on existing abilities can help. For example:

Remain Respectful When Speaking with Someone who is Confused

If someone is acting in a less than dignified manner, it may be tempting to treat the person in a demeaning or condescending way. Some caregivers of people with Alzheimer’s Disease may treat the person as if he were a child or may speak about him as if he is not present. This can produce negative effects as the person with dementia may be wounded emotionally. People who are treated like children tend to act like children. Conflicts may arise.


When speaking with someone who is confused:

If emotions begin to escalate, provide for the person’s safety and take a break. Caregivers who care for themselves through proper diet, rest, stress relief, and exercise may be less likely to experience burnout. Caregivers who are overwhelmed may be more likely to abuse or neglect the person with dementia.

Be Aware of Non-Verbal Cues When Communicating with Someone Who is Confused

Non-verbal communication, such as tone of voice and gestures, tends to “speak” louder than a person’s words. For example, if a person says “Have a nice day” but has her hands folded and rolls her eyes while saying those words, the gestures will usually outweigh the spoken words. Caregivers should be aware of unspoken messages they are sending and try to display an attitude that is confident, calm, and caring. If a caregiver appears tense and angry, the person with dementia may mimic those emotions and actions.

The person with dementia may have difficulty communicating with words, but her non-verbal cues may provide insight to the caregiver. Many emotional outbursts may result from an unmet need that the person cannot verbalize. For example, the person may begin removing clothing if he needs to use the bathroom or may begin crying if she is hungry.

Create an Environment That Encourages Effective Communication

The environment can have a positive or negative effect on communication. Reducing distractions can help. The television may agitate or distract someone with dementia. Music may provide a calming effect on the person, particularly if the music is a genre that the person liked in the past. Holding hands or other appropriate touch may have a soothing effect. A predictable routine may provide reassurance.

Familiar objects that elicit positive memories may help someone with dementia. Providing cues such as calendars, clocks, photographs, signs on doors, and labels on objects may help the person to stay more oriented.

Avoid Common Communication Problems Related to Dementia

Caregivers, family members, and friends often face many issues when trying to communicate with someone who has Alzheimer's Disease and other forms of dementia. Below are some specific tips for common issues that may arise when trying to communicate with someone who is confused. Sometimes techniques may work at some times and then again may not at other times, but these may be ideas to try, depending on the needs of the person: