Dementia is a progressive illness that, over time, will affect a person's ability to remember and understand basic everyday facts, such as names, dates and places. Dementia will gradually affect the way a person communicates. Their ability to present rational ideas and to reason clearly will change.

If you are looking after a person with dementia, you may find that as the illness progresses you'll have to start discussions to get the person to make conversation. This is common. Their ability to process information gets progressively weaker and their responses can become delayed.

Encouraging someone with dementia to communicate

Try to start conversations with the person you're looking after, especially if you notice that they're starting fewer conversations themselves. It can help to:

• speak clearly and slowly, using short sentences
• make eye contact with the person when they're talking or asking questions
• give them time to respond, because they may feel pressured if you try to speed up their answers
• encourage them to join in conversations with others, where possible
• let them speak for themselves during discussions about their welfare or health issues
• try not to patronise them, or ridicule what they say
• acknowledge what they have said, even if they do not answer your question, or what they say seems out of context – show that you've heard them and encourage them to say more about their answer
• give them simple choices – avoid creating complicated choices or options for them
• use other ways to communicate – such as rephrasing questions because they cannot answer in the way they used to

Communicating through body language and physical contact

Communication is not just talking. Gestures, movement and facial expressions can all convey meaning or help you get a message across. Body language and physical contact become significant when speech is difficult for a person with dementia. When someone has difficulty speaking or understanding, try to:

• be patient and remain calm, which can help the person communicate more easily
• keep your tone of voice positive and friendly, where possible
• talk to them at a respectful distance to avoid intimidating them – being at the same level or lower than they are (for example, if they are sitting) can also help
• pat or hold the person's hand while talking to them to help reassure them and make you feel closer – watch their body language and listen to what they say to see whether they're comfortable with you doing this

It's important that you encourage the person to communicate what they want, however they can. Remember, we all find it frustrating when we cannot communicate effectively, or are misunderstood.

Listening to and understanding someone with dementia

Communication is a two-way process. As a carer of someone with dementia, you will probably have to learn to listen more carefully.

You may need to be more aware of non-verbal messages, such as facial expressions and body language. You may have to use more physical contact, such as reassuring pats on the arm, or smile as well as speaking. Active listening can help:

• use eye contact to look at the person, and encourage them to look at you when either of you are talking
• try not to interrupt them, even if you think you know what they're saying
• stop what you're doing so you can give the person your full attention while they speak
• minimise distractions that may get in the way of communication, such as the television or the radio playing too loudly, but always check if it's OK to do so
• repeat what you heard back to the person and ask if it's accurate, or ask them to repeat what they said