Key takeaways
- Communication is about connection, not just information, and connection remains possible throughout the dementia journey.
- Non-verbal communication i.e. touch, tone, facial expression and body language often becomes the primary language in advanced dementia.
- How you say something matters as much as what you say.
- Meeting a person in their emotional reality, rather than correcting it, creates trust, calm and genuine connection.
If you have ever sat with someone in the later stages of dementia and felt unsure how to reach them, you are not alone. Words may come less easily. Sentences may not always make sense. The conversation you used to have may feel out of reach.
But communication has never been only about words. Long before language, human beings connected through touch, tone, gaze and presence. And for people living with dementia, these forms of communication do not fade, often they deepen.
What changes and what doesn’t
As dementia progresses, the ability to produce and understand words may decline. A person may repeat themselves, lose the thread of a conversation, use the wrong word for something or become quiet altogether.
What tends to remain, often for much longer than families expect, is emotional intelligence. The capacity to sense whether someone is warm or cold, present or distracted, genuine or going through the motions. Emotional memory is deeply held and remarkably durable.
This means that even when the content of a conversation is lost, its feeling remains. A calm, kind interaction leaves a person feeling settled. A rushed or tense one can leave them unsettled long after the moment has passed.
The language of presence
In compassionate dementia communication, presence is a skill. Being truly present, unhurried, attentive and calm communicates safety before a single word is spoken.
Some practical ways to offer this kind of presence:
- Approach from the front and at eye level, so as not to startle
- Make gentle eye contact and let it linger a moment before speaking
- Move slowly and calmly, especially during personal care
- Reduce background noise and distractions before trying to communicate
- Give a person time to respond without rushing or filling the silence
The power of touch
Touch is one of the most direct and powerful forms of communication available to us. A hand held gently, a shoulder lightly touched, a slow and steady stroke on the arm, these gestures convey care, safety and connection in ways that words often cannot.
For people who are no longer able to verbalise distress or comfort, physical touch can be both a question and an answer. It can calm, reassure and create a felt sense of not being alone.
Of course, touch should always be offered thoughtfully. Some people find it deeply comforting; others may need more space. Pay attention to the cues, a body that relaxes is welcoming the touch; one that tenses or pulls away is asking for something different.
Meeting people in their reality
One of the most significant shifts in compassionate dementia communication is the move away from correction and toward connection.
When a person living with dementia believes they need to pick up their children from school, or that their long-deceased mother is coming for dinner, the instinct of a loving family member is often to gently correct: ‘Mum, the children are grown up now.’ But correction, however well-intentioned, can cause distress, confusion and a sense of shame.
A different approach,sometimes called validation or emotion-focused communication, meets the person in their reality rather than pulling them out of it. It asks: what is the feeling behind what they’re saying? And how can I connect with that feeling?
In the example above, a compassionate response might acknowledge the feeling, ‘It sounds like you’re looking forward to seeing them’ and gently redirect, rather than correct. The emotional truth is honoured. The person feels heard.
What to say when you don’t know what to say
Sometimes families tell us they feel lost in the conversation, unsure what to bring up, how to fill the silence, or how to keep connecting when the person they love seems far away.
A few things that often work:
- Reminisce using photos, music or familiar objects from the person’s past, these can spark rich responses
- Narrate gently: ‘The sun is lovely today’ or ‘That smells wonderful, doesn’t it?’
- Sing together, musical memory is often the last to go, and familiar songs can open doors that conversation cannot
- Simply sit together in comfortable silence, with your hand nearby or gently offered
- Ask open, feeling-based questions: ‘Does this feel comfortable?’ or ‘Are you warm enough?’
You do not have to have the perfect words. You just have to be there and mean it.
Supporting families to communicate
At Videri, we work closely with families to share the communication approaches that work best for each resident. If your loved one responds beautifully to a particular song, or settles when you hold their hand in a certain way, we want to know. And if you’re finding visits difficult or emotionally exhausting, we want to support you through that, too.
Communication in advanced dementia is not a skill you either have or don’t have. It is something that can be learned, practised and deepened over time, and it is one of the most profound gifts you can offer someone you love.
Videri holds regular Demystifying Dementia workshops for families and carers, covering communication, connection and how to navigate the journey. We’d love you to join us. Find upcoming dates online or call us on 1300 015 406.
