Compassionate Communication and Dementia: Why It Matters So Much

Compassionate communication can make a huge difference for someone living with memory loss. It can reduce stress, build trust, and help a person feel more safe, understood and able to engage with daily life.

This is a topic close to my heart, because kind and thoughtful communication can unlock so much. It can help someone live more fully and also reduce the pressure, stress and anxiety felt by those caring for them.

This blog is for anyone supporting a person living with memory loss. In this first part, I explore what communication is and why dementia can affect it so deeply. In part two, I will look more closely at some of the key ways we can create safety and connection through better communication.

Why communication becomes harder with dementia

I often think of communication like a game of table tennis.

Each person is reading the other’s actions, verbal and non-verbal, while also taking in the environment around them and filtering out what is not important. Then they “hit the ball back” by responding in a way that keeps the exchange going.

When communication is working well, this happens quickly and naturally.

For someone living with dementia, however, this process becomes harder. Communication is no longer simple or automatic. It can be affected by changes in memory, slower processing, difficulty holding information in mind, and increased sensitivity to what is happening around them.

It can be helpful to think about communication in three parts:

• spoken language

• non-verbal communication

• the surrounding environment

Why spoken language can become difficult

Spoken language is often the hardest part of communication for someone living with dementia.

In everyday conversation, our brains do a huge amount of work very quickly. We listen to words, make sense of their meaning, follow the order they are said in, connect them to the context, and begin forming a response.

A lot of this depends on memory, attention and processing speed.

When memory is affected, this becomes much harder. Someone may still hear the words being said, but it can take longer to understand what has been said and to work out how to respond.

This is one reason why a person living with dementia may pause for longer before replying, or respond to something that was said earlier rather than what has just been asked.

It is also why long questions or too much information at once can feel overwhelming. If someone has to hold several pieces of information in mind before answering, the conversation can quickly become difficult to follow.

For carers and family members, this means two things are especially important:

• recognising that processing speed may be much slower

• keeping language simpler, shorter and easier to follow

Why non-verbal communication matters even more

When spoken language becomes harder, non-verbal communication often becomes even more important.

This includes:

• facial expression

• eye contact

• body language

• tone of voice

• posture

• pace

• gestures

People living with dementia may rely much more heavily on these cues when trying to understand what another person means and whether they feel safe.

A person may not remember every word that was said, but they may still pick up clearly on whether someone seemed calm, rushed, irritated, warm or reassuring.

This is why good communication is not only about what we say. It is also about how we say it.

A gentle tone, an open face, calm movement and patient body language can all help reduce anxiety and support understanding.

How the environment affects communication

The environment also has a huge impact on communication.

Most people without memory problems are able to filter out background noise and distractions when speaking to someone. In busy places, the brain often manages to focus on one conversation while pushing other sounds and movement into the background.

For someone living with dementia, this ability can become much weaker.

Background noise, music, television, several people talking, or a busy room can all make communication much harder. Too much stimulation can also increase confusion, agitation or anxiety.

This means that even when someone wants to communicate, the environment may be making that much more difficult.

A calm and quiet setting often helps. Turning off the TV, reducing background noise, and keeping the space simple can all support better communication.

This does not mean a person cannot enjoy busy places or social settings. But it does mean we may need to adjust our expectations. A pub or restaurant may be enjoyable socially, but it may not be the best place to expect a clear or relaxed conversation.

What this means for carers and families

When we understand why communication becomes harder, we can begin to adjust our approach.

That might mean:

• speaking more slowly

• asking one question at a time

• allowing longer for a response

• paying more attention to facial expression and tone

• reducing noise and distraction where possible

Most importantly, it means remembering that communication difficulties are not about a person being difficult, rude or unwilling. Often, they are doing their best in a situation that now takes much more effort than it once did.

Good communication begins with patience, compassion and realistic expectations.

Final thoughts

Good communication is not just about words. It is about pace, tone, expression and the environment around the person.

When we understand why communication becomes harder, we can respond more patiently and more compassionately. That can help a person living with memory loss feel safer, calmer and more connected.

At Ness Care Group, we offer training and support around communication, validation approaches and working well with people living with memory loss. If you would like to learn more, please get in touch.