The later stages of dementia

6. Communication

In the later stages of dementia the person is likely to have more problems with verbal communication. They may not understand what is being said to them and are less likely to be able to respond verbally as they may have limited or no speech. They may repeat the same phrase or sound, or may only be able to repeat a couple of words. Some people may start talking lots but their words don’t seem to make sense. In this case, try to identify the feelings that the person is trying to get across and respond to these. For example, if the person is smiling and chatting happily, respond to them in the same way.

Although the person may not be able to communicate verbally, they may still be able to show their needs and emotions in other ways. Rather than speaking, they may use behaviour, facial expression, gestures and sounds to try and communicate how they are feeling and what their needs are.

Try to support the person to communicate as much as possible. It can help to observe their body language, behaviour and facial expressions. Knowing the person and how they communicate will help you both to enjoy time together. It’s important to keep communicating with the person and look for opportunities for meaningful engagement (see ‘Meaningful activities’ above). Finding ways to engage the person’s senses can help.

When you’re thinking about how to communicate with the person, bear in mind their needs and background – including their cultural needs. For example, people from some cultural backgrounds may feel uncomfortable or distressed if you’re too close to them when you’re communicating with them.

Tips: communicating with a person in the later stages of dementia

  • keep eye contact when communicating
  • non-verbal communication (such as gestures, facial expression and body language) can help
  • smile
  • use appropriate physical contact (such as holding hands) to let the person know you are there and offer reassurance
  • don’t rush – allow plenty of time and look for non-verbal clues from the person
  • even if you don’t think the person can follow what you’re saying, continue talking to them clearly. They may still feel a certain way even if they don’t fully understand what you’re saying
  • consider responding to them in the way they respond to you (‘mirroring’ them).

For more information on communicating with a person with dementia see factsheet 500, Communicating.