Communication with a person with Alzheimer’s: calming phrases vs those that agitate

Table of Contents

1. Understanding communication difficulties

2. Fundamental principles

3. Phrases that agitate: to AVOID absolutely

4. Phrases that soothe: to PRIORITIZE

5. Common situations and good responses

6. Non-verbal language

Understanding communication difficulties {#comprendre}

Why does communication become difficult?

1. Memory loss

• Immediate memory gone: Forgets what has just been said
• Difficulty following a conversation

2. Language disorder (aphasia)

• Word finding difficulty: Searches for words, cannot find them
• Words replaced by others ("fork" becomes "the thing for eating")
• Incoherent sentences (altered syntax)

3. Loss of comprehension

• Long, complex sentences = incomprehensible
• Abstract concepts inaccessible (time, money, relationships)

4. Temporal-spatial disorientation

• Doesn't know the year, the day
• Thinks it's 1960, at 30 years old

5. Exaggerated emotions

• Disproportionate emotional reactions (crying, anger over details)

Consequence: "Normal" communication no longer works. Adaptation is necessary.

Fundamental principles {#principes}

1. Simplify

Short, simple sentences (5-10 words max).

One message at a time (no multiple ideas in one sentence).

Examples:

2. Speak slowly

Allow time for the brain to process information.

Pauses between sentences.

3. Calm, gentle tone of voice

The tone matters as much (if not more) than the words.

Soft, reassuring voice (even if repeating for the 10th time).

4. Emotional validation

Do not contradict, do not correct.

Welcome the emotion (even if based on a false reality).

"I understand that you are worried."

5. Avoid open questions

Closed questions = easier.

6. Use non-verbal language

Smile, eye contact, gentle gestures.

Communication is 70% non-verbal (especially in advanced stages).

Phrases that agitate: to AVOID absolutely {#phrases-eviter}

1. Direct contradictions

❌ "No, you are wrong!"

❌ "That's not true!"

❌ "You are talking nonsense!"

Why avoid?

Example:

Your mother says: "My mother is coming to pick me up tonight."

❌ "But no, your mother has been dead for 30 years!"

→ Crying, anxiety, feeling of loss

✅ "Are you thinking of your mother? You loved her very much."

→ Validation of the emotion, calming

2. Reminders of deficits

❌ "Have you forgotten already?"

❌ "I told you 10 times!"

❌ "You never remember anything!"

Why avoid?

Alternative:

3. Logical reasoning

❌ "But think a little!"

❌ "What you are saying doesn't make sense!"

❌ "Try to understand!"

Why avoid?

Alternative:

4. Test questions

❌ "Do you know what day it is?"

❌ "Do you remember me?"

❌ "What is my name?"

Why avoid?

Alternative:

5. Abrupt commands

❌ "Hurry up!"

❌ "Stop that right now!"

❌ "Do what I say!"

Why avoid?

Alternative:

6. Negations

❌ "No, we are not going out!"

❌ "Don't touch that!"

❌ "Don't worry!" (paradox: saying "don't worry" → reinforces worry)

Why avoid?

Alternative:

7. Infantilizations

❌ "Come on, be good!"

❌ "It's bedtime!"

❌ "Well done, you are a good boy!" (kindergarten tone)

Why avoid?

Alternative:

Phrases that soothe: to PRIORITIZE {#phrases-privilegier}

1. Emotional validation

✅ "I understand."

✅ "You are right to be worried."

✅ "That must be difficult for you."

Why does it work?

Example:

Your father: "My wallet was stolen!"

✅ "That's annoying, it must worry you. We will look for it together." (then distraction)

2. Reassurance

✅ "I am here, everything is fine."

✅ "You are safe."

✅ "We are taking care of you."

Why does it work?

3. Simple affirmative phrases

✅ "It's mealtime."

✅ "We are going for a walk."

✅ "Here is your coat."

Why does it work?

4. Offer simple choices

✅ "Do you want tea or coffee?"

✅ "Are we going to the park or the garden?"

✅ "Do you want to wear the blue sweater or the red one?"

Why does it work?

5. Compliments, gratitude

✅ "Thank you for your help."

✅ "You look very elegant today."

✅ "It was delicious." (even if she didn't cook)

Why does it work?

6. Evocation of positive memories

✅ "Do you remember when we went to the sea?"

✅ "Look at this photo, it was a beautiful day."

✅ "Tell me about your wedding."

Why does it work?

7. Gentle humor

✅ "We make a good team!" (after successfully doing something together)

✅ "What a beautiful sunny day!" (even if cloudy - if she is happy)

Why does it work?

Common situations and good responses {#situations}

Situation 1: "I want to go home" (while she is at home)

❌ "But you ARE at home, stop!"

✅ "Are you thinking of your house? Where was it?" (validation, then distraction)

✅ "We will go there soon. In the meantime, shall we have a coffee?"

✅ "You felt good there. Tell me about it."

Situation 2: "Where is my mother?" (deceased)

❌ "Your mother has been dead for 20 years!"

✅ "Do you miss your mother? You loved her very much."

✅ "Tell me about her, what was she like?"

✅ "She is busy right now, she will come later." (therapeutic lie, avoids pain)

Situation 3: Refuses to wash

❌ "You need to wash, you smell bad!"

✅ "We will feel better after a shower."

✅ "Do you want to wash now or after coffee?" (choice)

✅ "I will help you, it will be pleasant." (reassuring tone)

Situation 4: Accuses of theft

❌ "No one stole from you, you lose everything!"

✅ "It's annoying not to find it. Shall we look together?"

✅ "Where did you see it last?" (involvement)

✅ Then distraction: "Here, look at this photo."

Situation 5: Does not recognize you

❌ "But yes, it's me, your daughter!"

✅ "I am [First Name], I am here to help you." (do not insist on family link)

✅ Smile, gentle tone (even if hurtful for you)

✅ Continue to be present, caring (emotional link remains, even if not recognized)

Situation 6: Repeats the same question 10 times

❌ "I already answered you!"

✅ Respond calmly each time, as if it were the first

✅ Or write the answer on a paper, give it (can read and reread)

Situation 7: Wants impossible things ("I want to go to work")

❌ "You have been retired for 20 years!"

✅ "Did you like your job? What did you do?" (validation, evocation)

✅ "Today is your day off."

✅ Distraction: "We have something else to do together."

Non-verbal language {#non-verbal}

Why is it crucial?

In advanced stages, the person no longer understands words, but feels the emotions conveyed by non-verbal.

Rule: 70% of communication = non-verbal.

The right gestures

1. Eye contact

2. Smile

3. Tone of voice

4. Gentle touch

5. Slow, open gestures

6. Physical proximity

The gestures to avoid

❌ Crossing arms (closure)

❌ Pointing finger (accusatory)

❌ Sudden, quick gestures

❌ Speaking while looking away (feeling of being ignored)

❌ Touching without warning (can scare)

Practical daily tips

1. Mentally prepare

Before interacting: Breathe, calm down (if angry, it transmits).

2. Calm environment

Turn off TV, radio (background noise = confusion).

No multiple conversations (one person speaks at a time).

3. Use visual aids

Show while talking:

4. Allow time

No pressure: Allow time to respond, react (slow processing).

5. Adapt continuously

What works today may not work tomorrow (evolution of the disease).

Flexibility, creativity.

Training and tools to improve your communication

Communicating with a person with Alzheimer's can be learned.

Our Alzheimer training teaches you:

EDITH promotes communication:

Free guide: Practical communication tips.

Conclusion: Speak from the heart

Communication with a person with Alzheimer's is no longer a matter of rational words, but of emotions, validation, caring. The right phrases soothe, reassure, create bridges. The wrong ones agitate, hurt, isolate.

The keys:

1. ✅ Validate emotions (do not contradict)

2. ✅ Short, simple, positive phrases

3. ✅ Calm, gentle tone of voice

4. ✅ Caring non-verbal language

5. ✅ Infinite patience

Every word counts. Every smile counts. Every outstretched hand counts. Speak from the heart, not with reason. Your loved one will hear you.

DYNSEO resources for calming communication:

Words hurt or heal. Choose them with love. Your loved one will feel it, even if they no longer understand.