Communication tips for each Alzheimer’s disease stage

The progress of Alzheimer’s disease may feel like a Three Stages of Hell match between the caregiver and the care receiver. However, these tips may help you get the three count on your dementia communications issues. But first let’s establish what communication is and is not.

Communication and lack thereof


Alzheimer communication changes

  • Relating to each other.
  • An important element of relationships.
  • Expressing needs, desires, perceptions, knowledge and feelings.
  • Exchanging thoughts, messages, and information.
  • Listening and talking.
  • Attitude, tone of voice, facial expressions, body language.
  • Trouble finding the correct words.
  • Repetition of familiar words.
  • Describing an object instead of naming it.
  • Losing train of thought.
  • Trouble organizing words logically.
  • Reverting to a native language.
  • Speaking less frequently.
  • Relying more on gestures than on speaking.


Early stage

The patient can still take part in back-and-forth dialogue, engage in meaningful conversation, and participate in social activities. Conversely, they may repeat stories, not be able to find the right word, or become overwhelmed by too much stimulus.


  • Take into account that Alzheimer’s disease affects each person in a different way.
  • Do not exclude the individual from conversations with friends and relatives.
  • Address the person directly by name.
  • Listen patiently to what the person has to say.
  • Wait for the person to respond.
  • Do not interrupt them or finish their sentences unless they ask you for help.
  • Discuss with the person about the areas where they are still comfortable and the areas in which they may require help.
  • Determine which avenue of communication is most comfortable with.
  • Maintain a good sense of humor.
  • Open up your feelings honestly.

Middle stage

This is the longest stage and can span many years. The patient experiences increasing difficulty communicating and needs more hands-on care.


  • Give the person time to think about what they want to say.
  • Converse with the person using a 1-on-1 in an environment with a minimum of distractions.
  • Comfort and reassure the person.
  • Establish and keep eye contact.
  • Do not criticize or correct or argue.
  • Break down tasks into simple, one-step-at-a-time instructions.
  • Ask one question at a time; preferably yes/no questions.
  • Speak in a slow and clear manner. 
  • Use visual aids.
  • Point, touch, and gesture.
  • Written words may be more effective than oral communication.

Late stage

The duration of the final stage may range from weeks to years. The patient relies more and more on non-verbal communication. Constant care is generally needed.


  • Approach the patient from the front and identify yourself by name.
  • Promote non-verbal communication such as pointing and gesturing.
  • Use the other senses besides speech; sight, sound, touch, and smell.
  • Focus more on the emotions than on the words.
  • Similarly, your presence alone may be more important than anything you can say; or, as Queensryche would say, “I’m smiling next to you, in Silent Lucidity”.

Related Read:

- Let's communicate with people who have dementia