What should you not say to someone with dementia?

Speaking with a family member or friend living with dementia can present significant communication challenges. When your loved one is feeling confused or anxious, the last thing you want to do is say something that could upset them further.

While the person with dementia may have difficulty finding the right words to express themselves, the people supporting them should also be mindful of their language. There are certain questions and topics that you should avoid when speaking with someone with dementia so that you can ensure positive and peaceful conversations for everyone involved.

Keep in mind that your loved one can not always control the way they communicate – this is a symptom of their dementia. Responding with compassion and patience can go a long way to helping your loved one feel safe and supported.

10 things to avoid saying to someone with dementia

  1. Someone has passed away

The memory loss associated with dementia often leads people to forget about past bereavement. The person with dementia may speak about a former loved one as if they are still alive, and they may even become upset as to why this person never visits. For some people, a gentle reminder that someone has passed on can be helpful. For others, reminding them of a loved one’s passing can be painful and can lead them to experience the same grief and loss as when it first happened.

Try this instead:

Unfortunately, there is no right or wrong approach to this situation. It’s usually best not to avoid the topic as this can lead to frustration and further confusion. Think about whether it is in the person’s best interest to be told the news. If you do choose to tell them, gauge how they initially respond. This can help you understand whether you should tell the person again in the future, should they forget about the bereavement again. Make sure you have the conversation when the person is feeling comfortable and well-rested.

The Alzheimer’s Society advises that if the person is in the early stages of dementia, you may want to start talking about the death and see how they react. If they are already in the later stages of dementia, they may be less likely to understand and may find the news too distressing.

If you do not wish to tell them, you may want to try encouraging the person to talk about their loved one. Some people with dementia find speaking about their loved ones comforting, even if they do not realise that person has passed on. If you feel this would be too distressing or unhelpful, you can try distracting them by reassuring them their loved one will be by soon and then change the subject to a pleasant topic.

  1. “Remember when…?”

It can be tempting to try and jog someone’s memory by reminding them of a previous event or experience, but this can lead to confusion and frustration if the person doesn’t remember. Some people with dementia may also feel as if they are being ‘tested’ by these types of questions.

Say this instead:

Since you cannot always avoid talking about past situations or events, it’s best to change how you frame it. For instance, start the conversation with “I remember when…” rather than “Do you remember when…” This allows you to lead the discussion, and the person with dementia is free to either listen or join in.

  1. “You’re wrong.”

Correcting someone with dementia or telling them that they are wrong is often counterproductive. Saying things like, “No, you didn’t brush your teeth today” or “No, it’s Tuesday, not Wednesday” can leave them feeling discouraged or humiliated. Either the person is still alert enough to understand they’ve made a mistake and feel embarrassed, or they may not understand that they are wrong and feel unjustly called out.

Say this instead:

Although it can be challenging to go along with someone that you feel is wrong, it’s important to recognise that there is little benefit in arguing with the person or telling them that they are wrong. This can lead the person to feel attacked or distressed. In these situations, it is often best to simply change the subject or distract the individual with something fun and positive.

  1. “What did you say earlier?”

Open-ended questions about the past can be frustrating or confusing for people with dementia. If the person can’t remember the answer, they may become upset or worried about their memory loss.

Say this instead:

Instead of asking questions about their day, try to shift the focus on your own day. Allow the person with dementia the time to process the information or ask any questions. This may encourage them to share details about their own day, which you can use to spark conversations.

  1. “I already told you.”

Dementia often causes confusion and disorientation, and this can lead people to ask repetitive questions. Remember that your loved one is not trying to agitate you on purpose; they are likely wanting to feel included, seeking comfort, asking for help or trying to cope with feelings of anxiety and frustration. They may simply not remember that they’ve already completed a task or already asked the same question.

Say this instead:

Try to be patient and keep a calm and reassuring tone of voice. Think about what could be causing the behaviour. For instance, if they keep asking if it’s bedtime, they may be feeling tired or overwhelmed. If the person keeps asking about the time or date, consider placing a dementia-friendly clock in a visible place.

Remember that sometimes when a person with dementia asks repetitive questions, they may be looking for an emotional rather than a factual response. For instance, if the person keeps insisting that it’s Friday, they may be concerned that they have forgotten something rather than being interested in the actual day. Think about what thoughts, feelings, or concerns might be leading them to ask such questions.

  1. “Do you recognise me?”

If your loved one recognises who you are, you will likely be able to tell from how they interact with you. Often people with dementia can’t remember people’s names, but they still know that you are important to them. Try to avoid asking them outright if they know who you are, as this can lead them to feel guilty or embarrassed if they don’t remember. If the person does remember you, they may feel offended about the question.

Say this instead:

The way you greet the person may change depending on the stage of their dementia. You will need to judge for yourself if a simple greeting will suffice or if you should introduce yourself and your relationship to them. If you are unsure if the person remembers you, try and stick to a warm and simple greeting, such as “Hello, how are you?”

  1. “His/her dementia is getting worse”

Regardless of someone’s cognitive abilities or the current stage of their dementia, you should never speak about the person as if they are not in the room. Any questions or concerns about their condition should be handled where the person with dementia cannot hear them. They may get the sense that you are speaking about them, and this could make them feel distressed or embarrassed.

Try this instead:

Leave the room when you are discussing the person or their dementia to avoid not causing them any embarrassment or upset. Just remember that people with dementia should be allowed as much autonomy as possible over their own care. If the discussion is about the person’s care or support, you should try and include them in the conversation as much as is appropriate.

  1. Would you like coffee, tea, water or something else?

Long, complicated sentences or questions can be confusing or overwhelming for some people with dementia. As cognitive abilities become impaired due to dementia, it can be difficult for the person to process too much information simultaneously. Asking too many questions in a row or asking overly complicated questions may overwhelm them.

Say this instead:

Try using short and simple sentences. Rather than asking open-ended questions like, “What would you like to drink?” try asking, “Would you prefer coffee or tea?” Make sure you have the person’s full attention before you ask a question, and make sure the environment is quiet and not overly distracting so that they can focus on what you are saying.

  1. Do you need help with that, dear?

Although names like “dear”, “love”, or “honey” are often used with the best intentions, they can feel patronising for some people living with dementia, especially if you never used these terms before.

Say this instead:

Always use the person’s preferred name or title when speaking to them. If you’re not sure how you should refer to the person, it’s always best to simply ask them. Use simple words and sentences but don’t infantalise your language as this can feel patronising.

  1. “But you don’t look/sound like you have dementia”

Comments like “But you don’t look like you have dementia” may be well-intended, but they are based on a long-standing myth that people with dementia look or act a certain way. Since dementia is an umbrella term that encompasses many conditions, there is no one way that a person with dementia looks or acts.

Try this instead:

Let the person lead the discussion. If they want to share information about their dementia, they will. Use this as an opportunity to listen intently and provide emotional support – this alone can go a long way in allowing someone with dementia to feel appreciated and heard.

‘Outstanding’ dementia care at home

If you or a loved one has been diagnosed with dementia, know that there is support available to help improve your quality of life.

The Good Care Group has provided CQC-rated ‘Outstanding’ dementia care across the UK for over 10 years. Our professional and compassionate carers are well-versed in a wide range of best dementia care practices designed to comfort and reassure your loved one, reduce stress and anxiety and facilitate better communication.

We’re extremely lucky to have a team of in-house experts including an Admiral Nurse (dementia specialist nurse), who directly supports clients with complex dementia needs, as well as an occupational therapist, who supports those with adaptations at home as well as fall prevention.

With the gentle encouragement and support of a professional carer, people with dementia can continue living life as they always have in the comfort and safety of home.

We are here to support you and your family. Do not hesitate to contact us to discuss your dementia care needs with our friendly and approachable team.

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