Communication and aphasia

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As the disease progresses, the communication skills of a person with dementia will gradually decline and they will eventually have more difficulty expressing thoughts and emotions.


Aphasia is a condition that leads to problems using language correctly, either verbally or using written word. People with aphasia make mistakes with the words they use, choosing the wrong word, or putting words together incorrectly. It can also impact on someones ability to read or write.

Aphasia is caused by damage, due to brain injury or diseases such as dementia, to the parts of the brain responsible for understanding and using language. There are many types of aphasia, dependant on the location of the damage to the brain.

Aphasia & Mum

Mum suffered from fluent aphasia and she would talk for hours but as the disease progressed much of what she said stopped making any sense. She would put jumbled up words together to make incomprehensible sentences.

It isn’t easy communicating with someone who is making no sense and I came across a lot of people who simply dismissed Mum as soon as she started talking to them, as they didn’t know how to respond. When this happened Mum would get very embarrassed, upset and would become very quiet. It would really knock her confidence and I think it is one of the easiest ways to rob someone with dementia of their dignity.

Below are some tips on improving communication but my main advice is just ‘go with the flow’, don’t be embarrassed and respond as though you have understood, even when you haven’t.

Tips for improving communication

  • Where possible, approach the person with dementia from the front.
  • Minimizing other distractions such as the television, radio or other people’s conversation
  • Maintaining eye contact. If the person is sitting drop down to their eye level. Standing over someone can be intimidating.
  • Speak clearly and calmly. Make sentences short and simple. Make one point at a time.
  • Try to avoid questions that require complicated answers.
  • Don’t repeat questions that might embarrass the patient like ‘Don’t you remember?’
  • Ask one question at a time, too many choices can be confusing and frustrating.
  • Processing information will take the person longer than it used to, so be patient. If you try to hurry them they may feel under pressure.
  • Be aware of nonverbal communication; look for the feelings behind the words.

When you don’t understand what they are communicating

  • Listen actively and carefully.
  • Focus on a word or phrase that does make sense.
  • Respond to the emotional tone of the statement, not the words.
  • Stay calm and be patient.
  • Ask family members about possible meaning for words, names and phrases.
  • Respond as though you understand.
  • If necessary try a hug and change the subject.
  • Simply reply “wow” or “fab”.

Things not to do

  • Argue.
  • Order the person around.
  • Tell the person what they can and can not do.
  • Be condescending.
  • Talk about people in front of them.
  • Talk over or through a person as if they are not there.
  • Avoid whispering as it creates suspicion.
  • Don’t patronise the person or ridicule what they say.
Tips on improving communication.

Alzheimer’s Association have produced a very helpful booklet on how to improve communication through each stage of dementia.

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