Communication Problems - Learning a New Language

Did You Know

As their ability to communicate decreases, people with dementia may begin using the language that they first learned when they were children. Caregivers should find out what their loved ones' first language was and if possible prepare themselves to speak it with them, if even basically.

Caregiver Story

We've been through many different stages as Aunt Susan lost her ability to communicate. At first she used pronouns more often, saying "him" or "her" instead of a person's name. Later it was "that one" instead of an object's name. Now she cannot talk at all except to say "no," but will nod her head to indicate "yes" in response to questions she still understands, like, "Would you like some ice cream?" As her language got more limited, we had to learn how to communicate with her and figure out what she meant. The important thing was to make the effort and not give up trying.


Watch a video that describes typical progression of decreasing ability to speak in dementia (4 minutes long).

Watch a video that describes how to speak to a person with dementia so that he or she will best be able to understand you (1 minute 30 seconds long).

Watch a video that shows how to converse with a person with dementia (2 minutes long).

Difficulties with speech are often the first noticeable symptoms in people with dementia. At first, they may carry on normal conversations but simply forget a word. Or, they may have difficulty resuming the conversation after an interruption.

These minor communication issues happen to all of us at times. However, in people with dementia, language problems eventually become more noticeable. It becomes harder for them to remember or to learn new phrases, slang, or expressions. For instance, a person may begin confusing the meanings of words, perhaps saying that he doesn't want to eat “worms” when he really is talking about the fish you are serving for dinner. It is also more difficult for people with dementia to hold several ideas in their heads at once. They may jump from topic to topic without completing a coherent sentence.

It also becomes increasingly difficult for persons with dementia to understand what others are saying. In addition to not understanding certain words, rapid speech, high pitched speech, and complex speech all become difficult to follow.

What to Expect as Communication Problems Increase

As dementia progresses, people with dementia may use a set of common phrases or words more frequently, perhaps choosing language that they used when they were younger. In later stages, this small set of repetitive language may turn into a babble of language to the point that they can really no longer express what they want or need with words. Gradual loss of communication is one of the most difficult changes for caregivers, friends, and family members to accept, because they might feel that they can no longer understand or connect with their loved one.

Many people who have trouble communicating and have memory problems can remember songs from their youth or years past, since music and melodies are stored in a different part of the brain's memory center than words. So caregivers may want to try singing songs with their loved ones as another way to connect.

Communication In Late Stages of Dementia

In the later stages of dementia, communication may decrease until there is minimal to no communication. Grunting may replace words. As the ability to form and understand language fades, recognition of the person's own name may linger longer than understanding of other words. However, a caregiver's physical presence may be appreciated long after words no longer make sense or even after the person with dementia no longer recognizes people around him. The person may still understand tone of voice at this point; touch is also another important means of communication. If the person can tolerate it (and some people can not), caregivers can try giving a kiss, holding hands, giving a very gentle massage, or gently brushing hair.

To learn more about promoting successful communication, review our discussion on using a positive approach in caregiving.

Memory Bridge. The Foundation for Alzheimer's and Cultural Memory
This web page allows you to view a number of video clips from a documentary about communicating with people with Alzheimer's disease; the producers' philosophy is that it is always possible to connect with them in some way.
This web page discusses the stages of language changes that you can expect your loved one to experience as he/she progresses through the stages of dementia. Topics include how memory, comprehension, language skills, and social communication change with disease progression.
This web page discusses the challenges of communicating with your loved one with Alzheimer's disease and gives helpful advice on what you can do to make communication successful and engage your loved one in conversation.
Alzheimer's Society (United Kingdom)
This article offers advice on communicating successfully with your loved one, including discussion of dementia and language, listening skills, proper ways to get your loved one's attention, body language, and speaking clearly. The article also talks about other possible causes of poor communication (fantasy, pain, hearing discomfort, and poorly fitting dentures).
Alzheimer's Association
This booklet from the Alzheimer's Society is easy-to-read and presents practical suggestions for helping your loved one communicate, as well as working around hearing and vision limitations.
National Institute on Aging (NIA)
This resource list provides suggestions of websites, books, and other publications that can assist you in dealing with communication and behavior problems.