Listening is hard!

Listening when someone has dementia is even harder! 

Instead of listening to the words, listen to the meaning. I believe they are in there somewhere among the fog

Listening to Someone with Dementia: Finding the Underlying Meaning or Cause

Caring for a loved one with dementia can be a challenging and emotional journey. As their memory and cognitive abilities decline, it may feel like communication becomes more difficult. However, even though your loved one might struggle with words, understanding the underlying meaning or cause behind what they say can help you connect on a deeper level and provide the support they need.

It’s important to remember that dementia doesn’t just affect memory—it can also impact emotions, perceptions, and even how someone expresses themselves. By learning to listen not just to the words, but to the emotions, fears, and needs behind them, you can help reduce frustration and offer comfort. Here’s how to navigate conversations with a loved one with dementia and uncover the true meaning of what they’re trying to express.

1. Slow down and be Present in the Moment

The first step in understanding someone with dementia is simply being there for them. Set aside distractions and focus entirely on the conversation. Give them your full attention—eye contact, an open posture, and a calm, patient demeanor show that you’re invested in what they’re saying. Even if they repeat the same thing over and over, they are trying to communicate something important. Conversations may not follow a straight line, and responses might be delayed or repeated. That’s okay. Slow your pace, leave space for silences, and resist the urge to fill in words or rush the moment. Your presence alone can bring comfort.

Tip: Sit face-to-face, make eye contact, and use the person’s name often. These small actions can help ground the conversation.

2. Pay Attention to Non-Verbal Cues

As dementia progresses, some individuals may have difficulty expressing themselves with words. Words are only part of communication. Non-verbal cues—such as facial expressions, gestures, or body language—become incredibly valuable when words fail and can say more than actual words. A simple gesture like reaching for something or pointing may give you important context. A smile, a gentle nod, or a soft hand squeeze can say, "I'm here with you". If your loved one looks agitated or confused while talking, their emotions might be telling you more than the words themselves. Do they seem worried? Sad? Frustrated? These cues can provide valuable insight into what they might be trying to say. 

Tip: Pay attention to their emotions, even if the words don't seem to make sense. Respond to the feeling rather than the logic.

3. Validate Their Feelings

One of the most meaningful things you can do when someone with dementia communicates is to acknowledge and validate their emotions. Sometimes a person with dementia might say something that isn’t factually correct — for example, talking about going to work when they have long been retired or their words may seem disconnected or confused, their feelings are very real. For example, if they are upset and talking about something that doesn’t seem to make sense to you, saying something like, “I can see that you’re really worried right now” can help to calm them down and show empathy. By focusing on the emotion behind their words, you are helping them feel heard and understood, which can reduce anxiety and agitation.

4. Ask Open-Ended Questions

While yes or no questions are helpful, sometimes, open-ended questions encourage your loved one to express themselves more fully. Questions like, “Can you tell me more about what you’re feeling?” or “What’s on your mind?” can give you more insight into their thoughts and emotions. Even if their response doesn’t seem clear, it can guide you in the right direction to understand what might be causing them distress.

5. Look for Patterns in Their Speech

People with dementia may not remember the specifics of a situation, but they may still carry emotional memories that affect how they feel. For example, if your loved one frequently talks about feeling “lost” or “forgotten,” it could be a sign of anxiety about losing their independence or being isolated. Recognizing these patterns in what they say over time can help you understand their emotional state and how to best support them.

6. Use Familiar Routines and Objects

Sometimes dementia can cloud their ability to remember things, but familiar routines or objects can trigger memories and help them communicate. For example, if they seem confused or agitated, showing them a family photo or engaging them in a familiar activity (like folding laundry or a favorite hobby) can help center their thoughts and spark conversation. These comforting items often bring out a sense of calm and can make communication easier.

7. Provide Reassurance and Avoid Correction

When someone with dementia says something that isn’t quite accurate or doesn’t make sense, it’s easy to feel the urge to correct them. But instead of focusing on whether their statement is “right” or “wrong,” consider what their words might mean emotionally. Maybe they are expressing loneliness or fear. Instead of correcting them, try to reassure them. “I’m here with you, and you’re safe,” or “I understand you’re feeling upset, but let’s sit down together” can help ease their worries without causing distress over the details of what they’ve said.

8. Be Patient and Give Them Time

Dementia can cause processing delays in the brain, making it harder for your loved one to communicate their thoughts quickly. It’s important to be patient and allow them the time they need to express themselves. Rushing them or finishing their sentences can add stress and lead to frustration. Practice active listening—pause, give them space to speak, and then respond thoughtfully. The more time you give them, the more likely they will open up and communicate their underlying feelings.

9. Recognize and Address Their Needs

Sometimes, dementia causes people to act out or speak about things that may seem unrelated to their immediate environment. If they say they are “looking for their mom” or ask to “go home,” it may not necessarily mean they are confused about their location—it could indicate a deeper emotional need. Perhaps they miss the comfort of home or feel a longing for someone who was once a constant in their life. By offering a sense of reassurance or providing comfort, you help address their emotional needs.

10. Get Help When Needed

While you can do a lot to listen and understand, there will be times when professional help is needed to manage challenging behavior or emotions. It’s important to reach out to doctors, therapists, or support groups who can offer guidance, as they may have additional insights into the root causes of behavior changes or communication difficulties.

 

Questions:

 

• How can we create an environment where a person with dementia feels safe and comfortable enough to express themselves without fear of judgment or correction?

• How can we, as caregivers or family members, prevent our own frustration from influencing how we listen and respond to someone with dementia?

• How do we strike the balance between offering reassurance and not correcting a person with dementia when they speak about things that aren't factually accurate?

 

Conclusion

Listening to someone with dementia takes practice, patience, and empathy. By focusing on the feelings and emotions behind their words, you can provide the comfort and care they need. Understanding that they may not be able to communicate as clearly as they once could doesn’t mean they aren’t trying to tell you something important. With your support, your loved one can feel heard, valued, and cared for—no matter where they are in their dementia journey. Remember, it’s not always about the words; it’s about the connection, the understanding, and the love that lies behind them.

Questions for thought

 

• How have you found new ways to connect with someone you care about who is living with dementia?

• What small moments of joy or connection have stood out to you on this journey?

• What advice would you give to someone who is just beginning to navigate communication with a loved one with dementia?

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