Which of the following strategies is more effective when working with a patient with dementia?

Working with patients who are cognitively impaired presents an ongoing communication challenge. For instance, they likely will have trouble following any instructions about their care, including how and when to take prescriptions. Make sure someone can closely monitor care management, and try to involve a care partner whenever possible.

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• Related Articles
• What to expect
• What you can do to help
• Which of the following strategies is more effective when working with a patient of advanced age?
• Which of the following strategies is more effective when working with a visually impaired patient group of answer choices?
• Which of the following strategies is more effective when working with a deaf or hard of hearing patient?
• Which strategy would be contraindicated while communicating with a patient who has cognitive impairment?

Here are 15 tips for effectively working with and communicating with cognitively impaired patients.

1. Try to address the patient directly, even if his or her cognitive capacity is diminished.
2. Gain the person's attention. Sit in front of and at the same level as him or her and maintain eye contact.
3. Speak distinctly and at a natural rate of speed. Resist the temptation to speak loudly.
4. Help orient the patient. Explain (or re-explain) who you are and what you will be doing.
5. If possible, meet in surroundings familiar to the patient. Consider having a family member or other familiar person present at first.
6. Support and reassure the patient. Acknowledge when responses are correct.
7. If the patient gropes for a word, gently provide assistance.
8. Make it clear that the encounter is not a "test" but rather a search for information to help the patient.
9. Use simple, direct wording. Present one question, instruction, or statement at a time.
10. If the patient hears you but does not understand you, rephrase your statement.
11. Although open-ended questions are advisable in most interview situations, patients with cognitive impairments often have difficulty coping with them. Consider using a yes-or-no or multiple-choice format.
12. Remember that many older people have hearing or vision problems, which can add to their confusion.
13. Consider having someone call the patient to follow up on instructions after outpatient visits.
14. If the patient can read, provide written instructions and other background information about the problem and options for solutions.
15. Address potential issues of driving, getting lost, and home safety each time you see the patient. And, encourage regular physical activity, social activity, hobbies, and intellectual stimulation, as well as a healthy diet. Some studies link these approaches to the maintenance of cognitive function.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017

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Rethinking your listening and speaking strategies can help you communicate with a person who has dementia.

Communicating with someone who has Alzheimer's disease or a related dementia can be challenging.

A family member or friend with dementia may have difficulty understanding you, and you may have a hard time understanding what he or she is trying to communicate. There's potential for misunderstanding, confusion or frustration in both directions — making communication even more difficult.

You'll need patience, good listening skills and new strategies. Here's help easing your frustration and improving your communication.

What to expect

A person with dementia may have difficulty remembering words or communicating clearly. You might notice patterns in conversations, including:

• Having trouble with finding the right word
• Substituting words
• Describing an object rather than naming it
• Repeating words, stories or questions
• Mixing unrelated ideas or phrases together
• Losing a train of thought
• Speaking less often
• Reverting to a first language

What you can do to help

To improve understanding in both directions:

• Be patient. Take time to listen and allow time for the person with dementia to talk without interruption.
• Learn to interpret. Try to understand what is being said based on the context. If the person is struggling to get an idea out, offer a guess.
• Be connected. Make eye contact while communicating and call the person by name. Hold hands while talking.
• Be aware of your nonverbal cues. Speak calmly. Keep your body language relaxed.
• Offer comfort. If a person with dementia is having trouble communicating, let him or her know it's OK and provide gentle encouragement.
• Show respect. Avoid baby talk and diminutive phrases, such as "good girl." Don't talk about the person as if he or she weren't there.
• Avoid distractions. Limit visual distractions and background noise, such as a TV or radio, that can make it difficult to hear, listen attentively or concentrate.
• Keep it simple. Use short sentences. As the disease progresses, ask questions that require a yes or no answer. Break down requests into single steps.
• Offer choices. Offer choices when making a request for something a person might resist. For example, if someone is reluctant to shower, you might say, "Would you like to take a shower before dinner or after dinner?"
• Use visual cues. Sometimes gestures or other visual cues promote better understanding than words alone. Rather than asking if the person needs to use the toilet, for example, take him or her to the toilet and point to it.
• Avoid criticizing, correcting and arguing. Don't correct mistakes. Avoid arguing when the person says something you disagree with.
• Take breaks. If you're frustrated, take a timeout.

The challenges of communication evolve as the disease progresses. You will likely find that nonverbal communication with your family member or friend — such as touch or the comforting sound of your voice — will become not only important but also meaningful.

March 12, 2021

1. Communication and Alzheimer's. Alzheimer's Association. https://www.alz.org/help-support/caregiving/daily-care/communications. Accessed May 20, 2019.
2. Caring for a person with Alzheimer's disease: Your easy-to-use guide. National Institute on Aging. https://order.nia.nih.gov/publication/caring-for-a-person-with-alzheimers-disease-your-easy-to-use-guide. Accessed May 20, 2019.
3. Mace NL, et al. Characteristic behavioral symptoms in people who have dementia. In: The 36-Hour Day. 6th ed. Baltimore, Md.: The Johns Hopkins University Press; 2017.
4. Graff-Radford J (expert opinion). Mayo Clinic, Rochester, Minn. May 21, 2019.

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1. Alzheimer's sleep problems
2. Alzheimer's and wandering
3. Alzheimer's: Moving day tips
4. Alzheimer's and daily tasks
5. Alzheimer's: Preserving memories
6. Alzheimer's and long-term care options
7. Alzheimer's and family conflict
8. Alzheimer's and holidays
9. Caregiver stress
10. Home safety tips for Alzheimer's caregivers
11. Sharing Alzheimer's diagnosis

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Which of the following strategies is more effective when working with a patient of advanced age?

Which of the following strategies is more effective when working with a visually impaired patient group of answer choices?

Which of the following strategies is more effective when working with a deaf or hard of hearing patient?

Which strategy would be contraindicated while communicating with a patient who has cognitive impairment?