Forgetting things from time to time is human and completely normal. However, real memory impairments and related illnesses must be recognised and diagnosed in order to improve the affected person’s daily functioning. It is also important how loved ones communicate with a person with memory problems and how they are treated.

When a person begins to show memory impairments, has already been diagnosed with Alzheimer’s disease, or is living with dementia, communication can be emotionally very difficult for loved ones. The person changes, sometimes beyond recognition. They may become more withdrawn or more intense, as well as more impolite, irritable, or even angry and hostile.

The most important thing to remember is that dementia changes a person’s memory, thinking, and perception, but the need for safety, understanding, and respect does not disappear. In communication, the most important thing is not the “right answer,” but the right feeling.

A person with dementia may ask the same questions repeatedly, mix up the past and the present, and react unexpectedly. The world of a person with dementia may be different, but we can be there with them in that world. Small things — a warm look, a touch, a familiar song, or calm conversation — create a sense of safety and help preserve dignity even when words begin to fade.

It is often said that knowledge is power — the most important thing is to understand that this is an illness. This makes it easier not to feel offended, irritated, or angry. If a person’s personality traits have changed significantly due to the disease, it is important to remember that irritability, aggression, paranoia, and accusations are symptoms and should not be taken personally.

Experts from Estonia’s largest senior care home network, Südamekodud, have compiled universal recommendations on how to communicate with a loved one who has memory impairments.

1. Plan time for communication. Rushing does not suit people with memory impairments: they need a calm and stable environment.
2. Speak simply. Avoid complex words or sentences. If needed, rephrase what you said more simply or repeat it more calmly. If you do not understand the person, reflect what they said and ask whether you understood correctly.
3. Never speak to a person with dementia “like a child” — respect them, do not demean or insult them. They may not have hearing loss — do not necessarily speak loudly. Do not talk about them with others in the room as if they were not present.
4. If you want an older person to do something, give one instruction at a time. At the same time, avoid commanding or demanding. Find a playful or friendly way to give the instruction.
5. Do activities together that bring them joy and that they are able to do. Do not force them to do something they can no longer manage or to learn something new.
6. Do not argue. If you disagree with what is said, try to respond in a way that does not upset your loved one. For example, offer a distraction — ask about a favourite topic or suggest another activity. If the person says something that is not true, it is not always necessary to correct them. Often it is better to acknowledge the feeling rather than the fact. For example: “I can see that this worries you” or “You miss your home — that is completely understandable.”
7. Do not get angry. If you feel irritated, stop the conversation, step away, and try to calm down.
8. People with dementia may also behave problematically: shouting, swearing, getting angry, being aggressive, paranoid, and accusing loved ones of theft, losing items, etc. These are symptoms — it is not your former loved one, but the illness. If possible, redirect their attention away from what upset them and try to remain calm yourself. Do not blame them for losing things. If necessary, find their belongings and place them somewhere visible. If needed, purchase essential items in multiple copies so they are always available.
9. If you want to discuss something very important with a person with dementia, reduce background noise: turn off the TV and radio, and move to a quiet place without distractions. Before the conversation, also try to make sure your loved one is not hungry or in pain — this can also affect their ability to concentrate.
10. If you are struggling yourself, seek help from a specialist. Depending on the situation, this may be a care worker (if the older person already lives in a care home), a social worker, a neurologist, or a counsellor. If necessary, seek support from organisations dealing with dementia-related issues.
11. Do not forget humour — even if dementia has taken a severe form and changed the person, they may still retain a sense of humour. Keep joking and try to treat awkward situations with humour whenever possible.

Additional materials: Dementsuse Kompetentsikeskus

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