About Alzheimer's


Living With Alzheimer's >> Day-To-Day Issues | 04.24.15

Communication: the invisible barrier.

Problems with communication are an inevitable and distressing consequence of dementia. It’s often a two-way street: the person with dementia cannot articulate their thoughts, so caregivers are in the dark about their wants and their needs; and the person with dementia also cannot understand what is being said to them by the caregiver. Conversation in the traditional sense becomes impossible. It can be a time of incredible frustration, with both parties struggling to be understood by the other.

Why is this happening?

Since speech and language are some of the higher cognitive functions, they are among the losses that occur as dementia damages brain structures. In early stages, people will simply struggle to find the right words. Later, as the condition progresses, speech activity becomes completely degraded until it is completely gone.

Communication may also be affected by vision problems, hearing impairment or another physical ailment. The mental consequences of dementia, including anxiety, delusions and depression, can also reduce a person’s incentive to speak.

If you notice a sudden, drastic change in a person’s ability to communicate, the cause could be a stroke, so seek medical attention immediately. Since other medical conditions can also impact communication abilities, consult your doctor to determine if there are other causes that may need attention.

Here’s a summary of the various issues that could be causing communication problems for people with dementia:

Cognitive damage affecting memory and speech

Hearing problems

Impaired vision

Physical ailments




Sleep disorders

Medication side effects

Ill-fitting dentures

How should you respond?

Not being able to communicate can be a lonely experience. Do your best to ensure that the person with dementia does not become isolated and excluded from interactions with those around them. You should encourage them to participate in discussions to the best of their ability. To keep language difficulties from become too frustrating, keep things simple and low-key.

Later stages may prove difficult as verbal communication begins to fade completely. Even then, keep the person as involved as possible; don’t treat them as an invisible presence in the room. Remember, you can communicate with more than words. A kind look, a smile or the sound of your voice are all important ways to maintain a connection with the person. Physical non-verbal communication is also possible through something as simple as a warm hug or cradling a person’s hand with affection.

Since the pace at which impaired communication progresses is impossible to predict, make sure you discuss important care or late-stage issues with your loved one as soon as possible after a diagnosis. You want to make sure their wishes are followed as closely as possible, even after they have lost the ability to tell you so themselves.

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