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Communication Challenges to Expect During the Late Stages of Dementia

Published in Senior Living, Senior Services, For the Health of It Author: Jessalyn Middendorf, LPN, MBA, MPH, Benedict Court & Benedict Homes Director

The late stage of dementia disease may last from several weeks to several years and is considered the most severe. Persons in this stage show diminished ability to their environment and have difficulty controlling movement. Although they may be able to say words or phrases, they lose the ability to carry on a conversation or form full sentences. Things like communicating pain may be very difficult for a person living with Alzheimer’s.

As the disease advances, the person with dementia may rely on nonverbal communication such as facial expressions or vocal sounds.

Tips for successful communication:

  • Treat the person with dignity and respect. Avoid talking down to the person or talking as if he or she isn’t there.
  • Approach the person from the front and identify yourself.
  • Encourage nonverbal communication. If you don’t understand what is being said, ask the person to point or gesture.
  • Sometimes the emotions being expressed are more important than what is being said. Look for feelings behind the words or sounds.
  • Use touch, sights, sounds, smells and tastes as a form of communication with the person. For example, try:
    • Playing his or her favorite music
    • Reading portions of books that have meaning for the person
    • Looking at old photos together
    • Preparing a favorite food
    • Rubbing lotion with a favorite scent into the skin
    • Brushing the person’s hair
    • Sitting outside together on a nice day
  • It’s OK if you don’t know what to do or say; your presence and love are most important.

Just as your loved one benefits from your non-verbal communication, you can benefit from theirs as well. The following signs may be an indication they are trying to communicate with you:

  • Non-verbal signs: smiling, wincing, grimacing, sounds, and gestures
  • Behavioral signs: disruptions in sleep, shouting, agitation, and anxiety

Individuals in this stage require around the clock care. You are not alone — we are here for you. If you can no longer safely care for your loved one with dementia at home, CentraCare has residential living and specialized nursing care for people with memory loss.