What to say to someone with dementia, and what not to say

The short answer to what to say to someone with dementia is this. Answer the feeling, not the facts. If your mom is scared, say you can see she's scared and that you're staying. If she's wrong about the year, the room or who you are, let the wrong part go and talk to the part that's true, which is how she feels right now. Short sentences, one question at a time and a calm voice do more than any explanation.

That sounds simple, and it is hard, because everything you learned about talking to your parent assumed a brain that could keep up. The rest of this page gives you the actual words.

Why normal conversation stops working

When you correct someone, you're asking her to do a lot at once. She has to hold on to what you just said, compare it with what she believes, admit she got it wrong and update. Dementia damages memory and judgment, the two things that job needs most.

So a correction doesn't land as information. It lands as "you're wrong again," from the person she depends on. She may forget the conversation in ten minutes and still feel embarrassed or angry for the rest of the afternoon. You keep the facts. She keeps the bad feeling.

The Alzheimer's Association's advice for the middle stage is blunt about it. Avoid criticizing or correcting, and if she says something you don't agree with, let it be. That's the whole method in two lines. Everything below is how to do it when you're tired and she's said the same thing for the sixth time.

What to say to someone with dementia, line by line

Each of these lines follows the same pattern. Name the feeling, join her side, then give her one easy next thing to do.

The repeated question is the one that wears you down. Give the same short answer in the same easy tone every time, as if it's the first time. To her, it is. Introducing yourself by name when she doesn't recognize you spares her the panic of guessing wrong, and you can carry on with the visit like a friendly neighbor would. Guessing the stuck word gently, as a question, leaves her in charge of her own sentence.

A few habits make every script work better. Turn off the TV first. Sit at her eye level instead of standing over her. Say her name before you start. The NHS also suggests giving her time to answer, because she may feel pressured if you hurry her, and repeating back what you heard so she knows you got it.

What not to say to someone with dementia

Most of the phrases that blow up a visit are ones any of us would say to a healthy adult. They feel reasonable. They aren't, here.

"Do you remember?" is the big one. It turns a nice moment into a test she knows she's failing. Swap it for a statement she can join in on. Try "This is the beach house in 1978. You loved that porch," and let her add what she can.

"Dad died" is the next one. If she asks for a husband or parent who has died, telling her again makes her grieve again, often as hard as the first time. Answer the longing instead. "You're thinking about Dad. What was he like when you met him?" Some families also use a gentle fib like "He's out running errands." If that sits badly with you, the guide on therapeutic lying walks through when it's kind and when it isn't.

Also skip open questions with too many parts. "What do you want for dinner?" asks her to remember the options, picture them and choose. "Chicken or soup?" is a real question she can answer. The Alzheimer's Association suggests yes-or-no questions for the same reason.

What to say to a confused person with dementia

Confusion comes in a few common shapes. Here's how to answer each one.

She thinks it's a different year. Go there with her. The Alzheimer's Association calls this traveling with the person to where she is in time. If she's waiting for her kids to come home from school, ask what she's making them for snack.

She thinks you're someone else, often her sister or her own mother. Answer warmly in the role that keeps her calm. Correcting her usually just adds a stranger to the room. If she gets anxious, a photo of the two of you can help more than an explanation.

She doesn't know where she is. Skip the address. Tell her what she needs to feel safe. "You're safe. I'm staying for lunch." If she keeps asking to leave a house she's lived in for decades, that's the go-home loop, and the guide on when someone with dementia wants to go home covers it step by step.

Take Denise, whose father asked every evening around five whether he'd missed his shift at the plant. She used to remind him he'd retired in 1999, and he'd get angry and then sad. Now she tells him the foreman called and the line is down tonight, then hands him the newspaper and a cup of coffee. Most evenings that ends it in under a minute.

How to talk to someone with dementia who is delusional

A delusion is a fixed false belief. Common ones are that someone is stealing from her, that strangers are living in the house, or that her husband is cheating. The Alzheimer's Society explains that dementia makes it hard to put pieces of information together correctly, so the brain draws a false conclusion and holds on to it. The belief feels completely real to her, which is why proof doesn't help. Family Caregiver Alliance's advice is not to argue, and to respond to the feeling underneath.

Work through it in this order.

1. Keep your voice low and your words few. Don't defend yourself, even if the accusation is aimed at you.
2. Say the feeling out loud. "That would scare me too."
3. Take her side for a minute. Look for the missing ring together, or check the locks with her.
4. Move her somewhere else, to a snack, a walk to the mailbox, music or a small job.

If the delusion is about money going missing, there's a whole guide on what to do when she accuses you of stealing, including how to check that nobody really is taking advantage of her.

If she's seeing or hearing things that aren't there, you don't have to agree that they're real. You also don't have to argue. "I don't see him, but I can tell he's bothering you. Let's go to the kitchen" is honest and kind at the same time.

When a sudden change means call the doctor

Dementia usually changes slowly, over months. Delirium is different. MedlinePlus notes that delirium usually starts suddenly, over a few hours or a few days, and that people with dementia and older adults are at higher risk. Infections such as UTIs, medication side effects, dehydration and pain can all cause it. Many of those causes can be treated, which is why a fast change deserves a call, not a new script.

If she's in danger or someone could get hurt, call 911 and tell the dispatcher she has dementia. For advice at any hour, the Alzheimer's Association 24/7 Helpline is 1-800-272-3900.

Questions caregivers ask

What are three things not to say to someone with dementia?

If you only drop three, drop "Do you remember?", "I already told you" and any sentence that starts with "No, you're wrong." Each one asks her to use the memory she's losing, and each one tends to end with her upset and you frustrated.

What do you talk to someone with dementia about?

Talk about what she can still reach. That usually means older memories, her hands-on skills and the senses. Ask about the farm she grew up on, her first job, how she made her pie crust. Look at old photos without quizzing her. Talk about what's right in front of you, like the birds at the feeder or the smell of the coffee. Silence is fine too. Sitting together and folding towels counts as a visit.

What do you say to someone with dementia who wants to go home?

Don't tell her she's already home. Ask her about home instead. "Tell me about your house. Which room did you like best?" Then check whether she's hungry, tired or needs the bathroom, and offer to go "after dinner." The full approach, including what to say in a care home, is in the go-home guide.

What if I lose my temper and say the wrong thing?

You will, probably this week. Every caregiver does. Step out for a few minutes, come back and start fresh with something short. "I'm sorry I snapped. I'm here." She may have already forgotten. The point isn't a perfect record. It's getting back to calm faster each time.