Talk to Me: Communication as Comprehension Changes

Depending upon the rate at which your loved one’s dementia progresses, it can be difficult to gauge their ability to understand and retain information at any given time. Understanding stages of cognitive impairment and common behaviors associated with each stage will help, but determining their actual comprehension level is easier said than done for caregivers without professional dementia care training or lots of extra time on their hands to dive deep into research.

“Because cognitive decline can progress slowly, daily caregivers may not notice subtle signs that their loved ones’ ability to comprehend or communicate is becoming more taxing,” says Andrea Shapiro, Community Relations Director at YourLife™ of Coconut Creeka Memory Care community in Coconut Creek, Florida.

Shapiro advises that it’s important to register the person’s baseline behaviors, proclivities, and how they communicate now. “When caregivers are in tune with what’s ‘normal,’ subtle changes in their loved ones’ comprehension-related behaviors and responses will become more obvious.”

In this post, we’ll explore how comprehension abilities change for people as dementia progresses and how you can match your communication approach to help them understand you – and vice versa – more easily.


Take note of changes in how your parent communicates. Communication changes can signal comprehension changes and help you determine when you should modify your approach. Some changes in communication to look for include:

  • Not being able to find the right words.
  • Having difficulty remembering simple steps to everyday activities.
  • Inability to understand what certain words mean.
  • No longer able to pay attention during long conversations.
  • Showing frustration about their lessened ability to understand.
  • Mixing up simple words, such as pronouns or everyday items.


There will come a time when you may need to fine-tune your communication game in order to help your loved one participate in activities without frustration or feel included in conversations. After learning these and practicing them a bit, you’ll find that communication will once again become a little more natural to both of you.

  • Use visual cues and gestures.
    Babies learn to understand language by hearing a word and being directed to an object. While the dementia brain is not a child’s brain, some of the same techniques can apply. If you’re telling your mom her friend is coming to visit, show her a photo of the friend. If you want your loved one to use a spoon or brush their teeth, mimic eating or how to use a toothbrush.
  • Speak with context.

Context helps with comprehension. If your loved one can’t see what you are talking about, it helps to form a picture with details. Instead of “Let’s put on your pee-jays,” you can say, “It’s nighttime. I’m here to help you get ready for bed,” which will make the connection less confusing if they have time disorientation or forget the nickname for pajamas.

  • Avoid pronouns.
    It can be difficult for someone with dementia to make the connection between ‘she’ and which she you are referring to. Instead, say the person’s name. No matter how repetitive it is, it will get the ‘who’ cleared up so they can focus on the rest of what you have to tell them.
  • Slow down and simplify your speech.
    Talking too fast can make comprehension difficult for your loved one. Simply slowing down your speech can help immensely. Also, avoid conjoining two thoughts. Instead, combine them into one. Instead of “Nancy called and said she’s coming over to visit you later,” say, “Nancy is coming to visit at 1:00.” Give short, succinct instructions as you guide them through each step of a task and avoid using a passive voice or adding unnecessary information, which makes their brain do extra work to figure out what you are saying. Instead of “Put on your blue socks and those shoes we got you at Macy’s,” have their items ready and say, “Please put on these socks,” wait for them to do so, then “now please put on these shoes.”
  • Give them simple choices.
    Instead of asking what they want for dinner, ask them if they want chicken or fish. This will help them focus their thoughts and not lose sight of what it is they are supposed to be deciding.
  • Be aware that ‘yes’ and ‘no’ may be default answers.

When people with dementia require care from others, they may be used to hearing questions that aren’t really questions. Don’t ask, “Will you take these pills for me?” or “Isn’t it time to get up now?” If they need to take their pills or wake up, don’t give them a ‘no’ option that will sound like a refusal to cooperate. And make sure that when you really need them to answer a question, you aren’t just getting a default answer. TIP: Use a positive tone of voice if you sense resistance. If you’re happy they’re taking their medication, they are more likely to be too.  

  • Make eye contact and use positive body language.
    Your body language and facial expressions can help them comprehend much more easily when they match what you are saying. Be aware of the message your body language is sending. Are you towering over them? Glowering at them? Positioning yourself at their eye level will minimize any threatening vibes you may be sending and, if you can’t make your face pleasant when frustration takes over, at least make it neutral. Focusing on making your body language and tone of voice positive can help you stay calm and positive as well.
  • Be patient.

If your loved one doesn’t acknowledge you right away, it doesn’t mean they didn’t hear you or are ignoring you. Give them time to process what you are saying and to process their response.

Need specific tips for communicating with your loved one as their memory loss progresses? Call the dementia care experts at YourLife™ of Coconut Creek! ​954-228-6319


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