One of the most frustrating challenges for people with dementia is losing the ability to communicate. They can struggle to express themselves clearly or understand what others are saying, making it difficult for themselves and their family and carers.
As part of our webinar series, guest presenter Garrie O’Toole from Dementia Australia shared strategies for communication with people living with dementia.
Below are some of the highlights from the webinar.
Types of dementia and what they do to your brain
Dementia refers to a broad set of symptoms caused by brain diseases. “Dementia itself is not a specific disease but rather describes symptoms related to progressive cognitive decline,” explains O’Toole.
While normal ageing involves some cognitive slowing, dementia leads to significant disruptions in daily functioning, which is not normal.
There are over 150 types of dementia. The four primary types are:
- Alzheimer’s disease, which is the most common type, progresses gradually, with cognitive decline becoming more noticeable after several years.
- Lewy body dementia, which is related to Parkinson’s disease, presents across a spectrum with varying motor and cognitive symptoms.
- Vascular dementia, which is associated with reduced blood flow to the brain, often following small strokes.
- Frontotemporal dementia, which is caused by progressive damage to the frontal and/or temporal lobes of the brain.
What you should know about dementia
Dementia is the second leading cause of death in Australia, with nearly 421,000 Australians living with dementia currently. However, for every diagnosed person, it is estimated that three more people are likely to have one of the diseases causing dementia but remain undiagnosed.
“The slightly frightening fact is that most of the diseases that lead to dementia usually start 20-30 years before symptoms become obvious,” says O’Toole.
With the number of people with dementia expected to double in the next 20 years, mainly due to the ageing population, we are most likely to be interacting with people living with dementia.
“Skilled dementia support needs to become core business for all aged care providers—whether in residential care, community care, acute care, or even local medical clinics,” O’Toole emphasises.
- Dementia affects each individual differently, with symptoms and retained abilities varying from person to person. “Their support needs and communication can change from day to day, which means we need to be flexible and creative in our approach,” adds O’Toole.
- Effective care requires a patient-centred approach—knowing the person beyond their medical diagnosis and understanding the individual’s life, values, and experiences.
- Collaboration with family members and carers is critical, especially for support workers. Family caregivers often know what works best for the person, understand their triggers, and can explain behaviours that might seem unusual.
Impact of dementia on communication
Dementia adds another layer to the normal communication challenges that come with ageing, impacting communication by causing word-finding difficulties, reduced comprehension, and challenges in organising thoughts coherently.
“Many people with dementia become functionally aphasic, meaning they can no longer communicate verbally in a meaningful way. However, this doesn’t mean they’ve stopped communicating altogether; they’re just not doing it verbally,” says O’Toole.
Key communication difficulties include:
- Reduced ability to express needs.
- Slower processing time for interpreting words and forming responses.
- Difficulty understanding complex information.
- Increased distractibility and trouble maintaining focus.
These difficulties can lead to frustration, low self-esteem, social withdrawal, confusion, boredom, behavioural changes like wandering, and increased isolation, elevating the risk of depression and anxiety in people with dementia.
How to communicate effectively with people living with dementia
As support workers, knowledge of dementia and specific dementia-related communication strategies are essential.
A checklist approach can help ensure optimal communication conditions that address common communication barriers, such as reducing environmental distractions, ensuring sensory aids like glasses or hearing aids are in place, and making sure the person is comfortable.
It’s also important to check for emotional challenges, such as being frightened or anxious, and understand that pain in people with dementia can make it difficult for them to communicate. O’Toole adds, “Sometimes people with dementia may not remember who you are, so reestablishing social connection is really important”.
Tips for successful communication
As dementia worsens, verbal communication declines, often shifting toward non-verbal behaviours like actions and gestures.
- Changes in behaviour (wandering) or extreme behaviour (screaming) often mean they are trying to communicate unmet needs such as boredom, fear, pain, or hunger.
- Even if verbal abilities decline, people with dementia still experience emotions and require respect, love, and safety.
- Non-verbal cues such as tone of voice and body language become critical, as people with dementia may react more to these than words.
It’s important to note that people with dementia can lose proficiency in English if it is their second language, reverting to their childhood language. Understanding the person’s culture or learning key phrases and words can be helpful.
Strengths-based approach
A strength-based approach to communication focuses on the abilities retained by people with dementia.
- Adjust communication styles, such as allowing time for the person to respond, speaking slowly, making eye contact and using gestures or props to communicate if needed.
- Avoid asking “why”, as it often causes confusion or anxiety.
Key communication strategies
There are three key communication strategies to engage with people with dementia.
Reality orientation
Validation therapy
Reminiscence therapy
Supporting people living with dementia
Dementia Australia is the national peak body supporting people living with dementia, their families, and carers. You can find helpful resources on communication strategies on their website, including education resources and training at Dementia Training Australia. You can also access on-the-go training and information on the Ask Annie app, which is designed for care workers supporting people with dementia.
For more information about supporting people with dementia, explore our resources, such as the Mable Dementia Topic Library or our tips for supporting people with dementia.
Watch other webinars in our webinar series to learn more about supporting others as an independent support worker.
