title: Alzheimer's language disorders: understanding aphasia and communicating effectively
description: Complete guide Alzheimer's language disorders: types of aphasia, evolution, communication impact, adaptation strategies, non-verbal communication techniques, practical advice for caregivers to maintain connection despite loss of words.
keywords: Alzheimer's language disorders, Alzheimer's aphasia, word loss, Alzheimer's communication, word-finding difficulty, speaking Alzheimer's, understanding Alzheimer's, non-verbal language
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Alzheimer's, language disorders, aphasia, communication, word loss, word-finding difficulty, speech, understanding, non-verbal language
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Reading time: 29 minutes
"Mom is searching for her words, she says 'the thing for eating' instead of 'fork'." "Dad keeps repeating the same phrases." "She doesn't understand what I'm saying anymore." "We can no longer have real conversations." "Words disappear, and with them, our connection."
Language disorders are at the heart of Alzheimer's drama. Words are lost, sentences disintegrate, understanding collapses. Your loved one, who used to talk, laugh, tell stories, gradually becomes mute, or worse, trapped in chaotic language that no longer makes sense. This loss of language breaks communication, isolates, frustrates, and cruelly symbolizes the progressive erasure of the person.
But communication is not limited to words. By understanding language disorders, adapting your way of speaking, and using non-verbal language, it is possible to maintain a connection, continue to understand each other, and preserve a valuable human connection despite the loss of words.
This guide explains how language deteriorates in Alzheimer's, and provides you with concrete strategies to continue communicating effectively with your loved one.
Table of Contents
1. Understanding language disorders
2. Evolution of disorders according to stages
3. Strategies to facilitate communication
Understanding language disorders {#comprendre}
What is aphasia?
Definition: Language disorder (expression and/or comprehension) due to brain lesions.
In Alzheimer's: Progressive aphasia (unlike stroke = sudden).
Affected brain areas:
- Broca's area (language production)
- Wernicke's area (comprehension)
- Connections between areas
- "I want the... the thing... you know..." (looking for "phone")
- Replaces with vague word: "The thing," "the doohickey"
- Circumlocutions: "The thing for writing" (pen)
- Says "fork" for "knife"
- Says "dog" for "cat"
- Says "tomato" for "roof"
- Complex instructions: Unintelligible
- Long sentences: Loses the thread
- Abstract words: No longer grasps the meaning
- Words out of order: "Eat me want"
- Loss of grammar: No more conjugation, agreements
- You: "Do you want to eat?"
- She: "Do you want to eat?"
Alzheimer's gradually destroys these areas → Language disintegrates.
Types of disorders
1. Word-finding difficulty (anomia)
Main symptom: Can't find the word they are looking for.
Examples:
Early stage: Loss of rare words, proper nouns.
Advanced stage: Loss of common words.
2. Paraphasias
Word substitution (errors):
Semantic paraphasia: Word with similar meaning:
Phonemic paraphasia: Word with similar sound:
Neologisms: Made-up words (don't exist).
3. Comprehension disorders
No longer understands what is said to them:
Advanced stage: Even simple words become unclear.
4. Syntax disorders
Poorly constructed sentences:
5. Echolalia
Repeats what is said (like an echo).
Example:
Advanced stage: Automatic repetition, without understanding.
6. Perseveration
Repeats the same word/phrase over and over.
Example: Says "yes yes yes" 20 times, or repeats the same question 10 times.
7. Loss of language (mutism)
Very advanced stage: No longer speaks at all (or incomprehensible sounds).
Verbal communication impossible.
This is NOT intentional
Your loved one is not doing it on purpose by saying wrong words, repeating, not understanding.
Damaged brain: Language out of control.
Principle: Patience, adaptation, no reproaches.
Evolution of disorders according to stages {#evolution}
Mild stage
Occasional word-finding difficulty:
Comprehension: Generally preserved (simple instructions OK).
Conversations possible: With adjustments.
Moderate stage
Frequent word-finding difficulty:
Reduced comprehension:
Repetitions (echolalia, perseveration) appear.
Difficult conversations: Requires significant adaptation.
Advanced stage
Very poor language:
Almost no comprehension:
Progressive mutism: Towards the end, no longer speaks.
Verbal communication impossible → Non-verbal communication crucial.
Strategies to facilitate communication {#strategies}
General principles
1. Simplify language
Short sentences: Max 5-7 words.
Simple words: Concrete (not abstract).
One idea at a time.
2. Speak slowly
Slow pace: Gives time to process information.
Pauses between sentences.
3. Calm, gentle tone
Don't shout (worsens confusion, anxiety).
Reassuring voice.
4. Look in the eyes
Eye contact: Captures attention.
Face-to-face (don't speak from afar).
5. Repeat if necessary
If they don't understand: Repeat (same words, or rephrase more simply).
Patience: No visible annoyance.
Strategies according to type of disorder
For word-finding difficulty:
If searching for a word:
Give time: Patience (10-20 sec), may find it.
Help discreetly:
Don't finish sentences systematically (frustrating for them).
Accept circumlocutions: Understand intention (don't constantly correct).
For paraphasias:
If saying the wrong word:
Understand intention (context).
Example: Says "dog" pointing to cat → Understand they are talking about the cat.
Gently correct (if necessary): "Ah, the cat, yes."
Don't insist if error persists (no argument).
For comprehension disorders:
Simple instructions:
One instruction at a time:
Concrete words: "Put on your shoes" (OK). "Get ready" (too vague).
Gestures accompany: Show shoes while saying "put on your shoes".
Verify understanding: Observe if they execute (if not, rephrase).
For echolalia:
If repeating like an echo:
Rephrase as a statement:
Ask closed questions (yes/no) rather than open ones.
For perseveration:
If repeating in a loop:
Calmly respond the first time, then gently ignore (no annoyance).
Redirect attention: Change topic, activity.
Visual tools
Show objects:
Accompany words with object: "Do you want to drink?" (show glass).
Photos, pictograms: Visual supports (if words alone not sufficient).
Gestures: Mimic action ("eat": gesture hand to mouth).
Writing: Write word in large letters (if they still read).
Avoid
Open-ended questions: "What do you want to do?" (too complex).
Long/complex sentences.
Speak fast, loud.
Interrupt when they speak (even slow, incoherent).
Constantly correct (humiliating).
Talk about them in their presence (as if absent).
Non-verbal communication {#non-verbal}
Why it's crucial
Verbal language is lost → Non-verbal communication becomes essential.
Advanced stage: Only means of communication.
Types of non-verbal communication
1. Eye contact
Eye contact: Connection (I am here, I see you).
Looking in the eyes: Conveys attention, love.
2. Touch
Hand on hand: Comfort.
Caressing hair, cheek: Tenderness.
Gentle massage: Soothing.
Holding hands: Reassuring physical connection.
Caution: If very modest/refusing contact, respect.
3. Facial expressions
Smile: Positive emotion transmitted (even if they no longer smile, they sense kindness).
Serene face: Reassures.
Avoid: Frowning, tension (perceived as a threat).
4. Tone of voice
Even if words not understood, tone of voice captured:
Gentle, warm tone: Soothes.
Annoyed, cold tone: Distresses.
Singing: Melody can soothe (even without words).
5. Body language
Physical proximity: Close to them (not distant).
Open posture: Face them, relaxed.
Slow gestures: Not abrupt (frightening).
6. Music
Listen to music together: Emotional communication (no words, but emotional sharing).
Favorite songs: Musical memory preserved (may hum, even if no longer speaks).
7. Shared activities
Do together (without words):
Presence = Communication.
Communication through emotional validation
If expressing emotion (even confusingly):
Validate: "I see you are sad/mad/happy."
Don't deny: "No, you have no reason to be sad" (invalidates).
Accompany emotion: Be there, reassure.
Managing frustrations and misunderstandings {#gerer-frustrations}
Frustration of your loved one
Can't find words anymore → Anger, tears, agitation.
Can't understand anymore → Anxiety, panic.
Strategies:
Stay calm: Your calm soothes.
Reassure: "It's okay, I'm here, we'll understand each other."
Don't insist: If too frustrated, change subject, come back later.
Value attempts: "You're trying, that's good."
Distraction: Redirect attention to a soothing activity.
Caregiver's frustration
Exhausting repetitions, mutual misunderstanding → You're at your wits' end.
Strategies:
Break: If too frustrated, go out for 5 min, breathe.
Accept limitations: Perfect communication impossible (accept it).
Look for connection moments: Even without words (looks, smiles, touch).
Support: Support groups, psychologist (share frustrations).
When verbal communication fails
Shift to non-verbal: Gesture, touch, presence.
Accept silence: Being together without talking = OK (presence is enough).
Let go: Not understanding everything, not saying everything = Normal (disease).
Maintaining connection despite word loss {#maintenir-lien}
Communication isn't just words
Connection = Presence, attention, love (not just words).
Even mutism: Connection possible (looks, touch, emotions).
Activities maintaining connection
Music:
Photos:
Walks:
Body care:
Laughter:
Speak even if they no longer respond
Keep talking (even at an advanced stage):
Tell them about your day, read a story, sing:
Don't expect responses: Monologue OK (they hear you).
Accepting a new form of communication
Before: Rich conversations, deep exchanges.
Now: Simplified communication, silences, non-verbal.
Different, but not absence of connection.
Mourning the old communication, but celebrating the new one (also precious).
Role of the speech therapist
When to consult
Mild/moderate stage: Speech therapist can help.
Advanced stage: Less effective (but caregiver advice useful).
What the speech therapist provides
Assessment: Precise language disorders.
Rehabilitation:
Caregiver advice: Adapted communication techniques.
Swallowing prevention: Monitoring (if oral-facial aphasia).
Language stimulation with EDITH
EDITH program offers language-stimulating games:
Vocabulary games: Name images, categorize.
Verbal memory games: Repeat words, sentences.
Auditory stimulation: Listening, understanding.
15 min/day: Maintaining language abilities (mild/moderate stage).
Complement: Speech therapy, daily communication.
Testimonials
Claire, caregiver for her mother
"Mom can no longer find her words. At first, I finished her sentences (impatience). The speech therapist told me: 'Let her search, help discreetly.' Now, I wait, I suggest the start of the word. Sometimes she finds it. And even if not, we understand each other (gestures, context). Less frustration (for her, for me)."
Marc, son of his father
"Dad advanced stage, hardly speaks anymore. But we listen to music together every evening. I sing, he hums (sometimes). No words, but connection. Music = Our language now. Precious."
Sophie, caregiver for her husband
"I talk to my husband even if he no longer responds. I tell him about my day, read the newspaper, sing. The doctor told me: 'Continue, he hears, it matters.' Sometimes, he squeezes my hand. That's his response. Different communication, but real."
Conclusion: Beyond words
Words disappear, but the connection can remain. Communication is not only language, it is presence, look, touch, shared emotion. Even when words are lost in Alzheimer's fog, your voice, your hands, your love continue to speak. And your loved one, even silent, hears, feels, still exists through your connection.
Keys to communicate despite language disorders:
1. ✅ Simplify (short sentences, simple words, slowly)
2. ✅ Adapt (according to type of disorder, disease stage)
3. ✅ Visual tools (show, mimic, gestures)
4. ✅ Non-verbal communication (touch, look, presence)
5. ✅ Infinite patience (don't rush, don't constantly correct)
6. ✅ Value attempts (encouragements)
7. ✅ Maintain connection (shared activities, music, presence)
You are not alone. Our Alzheimer's training details adapted communication. EDITH stimulates language (mild/moderate stage). Free guide: All daily strategies.
DYNSEO resources to maintain communication:
Words fade away, but you remain. And it's you, your presence, your patience, your love that speaks now. Every simple word you say, every hand held, every song hummed: all of it says "I am here, you are not alone, I love you." And that message, beyond words, transcends all the aphasias in the world. Keep speaking. With words or without. Your voice remains the beacon in the storm.