Communication Techniques
Communication is one of the most important skills in dementia care. As the condition progresses, a person's ability to understand and express themselves changes — but meaningful communication is always possible with the right approach.
Why this matters:NICE NG97 recommends that care workers are trained in communication techniques that support people living with dementia. The CQC's “Caring” key question specifically assesses whether people are treated with compassion, kindness, dignity, and respect — all of which depend on effective communication. Communication difficulties are often the root cause of distressed behaviour, so investing in good communication is also a key prevention strategy.
General Communication Principles
- •Always assume the person can understand you — even if they cannot respond verbally, they may understand more than you think.
- •Be patient — allow extra time for the person to process information and formulate a response.
- •Enter their reality — rather than correcting factual errors, validate the emotion behind what they are saying.
- •Use non-verbal cues — gestures, facial expressions, and touch can convey meaning when words fail.
- •Reduce background noise — turn off the television, close doors, and find a quiet space for important conversations.
- •Be consistent — use the same words and phrases each time; avoid changing how you refer to things.
Communication Do's & Don'ts
Below are evidence-based communication tips organised by category. These are drawn from NICE guidance, the Alzheimer's Society framework, and best practice in UK care homes.
Getting Attention
✓Do
- Approach from the front where possible
- Use the person's preferred name
- Make eye contact (respect cultural preferences)
- Gain attention before speaking — gentle touch on arm if appropriate
✗Don't
- Startle the person from behind
- Speak from another room
- Assume the person has heard you if they haven't responded
Speaking
✓Do
- Speak clearly and at a slightly slower pace
- Use short, simple sentences
- Give one piece of information at a time
- Allow extra time for the person to process and respond
- Use a calm, warm tone of voice
✗Don't
- Use complex or long sentences
- Rush the person or finish their sentences
- Use jargon, idioms, or sarcasm
- Shout or raise your voice
- Talk over the person or to others about them as if they're not there
Non-Verbal Communication
✓Do
- Use gestures and point to objects
- Maintain open and relaxed body language
- Use facial expressions to convey warmth and reassurance
- Ensure good lighting and reduce background noise
- Sit at the person's level
✗Don't
- Stand over the person or loom
- Cross your arms or appear defensive
- Rely on written communication alone (reading may be affected)
- Underestimate the power of touch and presence
Active Listening
✓Do
- Listen carefully and try to understand the emotion behind words
- Repeat back what you think the person means
- Validate feelings even if the facts are incorrect
- Use phrases like 'I can see you're upset' or 'Tell me more'
- Be patient — silence can be meaningful
✗Don't
- Correct the person aggressively or argue with their reality
- Dismiss feelings or say 'don't be silly'
- Ignore attempts to communicate
- Assume non-verbal responses mean understanding
Non-Verbal Communication
As dementia progresses, non-verbal communication becomes increasingly important. Research suggests that up to 93% of communication is non-verbal (Mehrabian, 1971). When verbal language diminishes, the person relies more on tone of voice, facial expression, body language, and touch.
Facial Expression
Maintain a warm, relaxed expression. People with dementia are highly attuned to facial expressions and can sense tension or anxiety.
Body Language
Adopt an open posture. Sit at the person's level rather than standing over them. Avoid crossing your arms, which can appear defensive.
Eye Contact
Make gentle eye contact (respecting cultural norms). This conveys attention and interest and helps the person focus on you.
Touch
Appropriate gentle touch — a hand on the arm or shoulder — can communicate reassurance and warmth. Always be guided by the person's preferences and cultural background.
Tone of Voice
Use a calm, warm, and respectful tone. Avoid sharp, raised, or sing-song voices. The emotion in your voice often matters more than the words you use.
Gestures & Pointing
Use simple gestures to support your words. Point to objects, mime actions, and use visual cues to aid understanding.
Active Listening
Active listening means giving your full attention and genuinely trying to understand the meaning and emotion behind the person's words — even when those words don't make logical sense. It is one of the most powerful communication tools in dementia care.
Quick Reference: Communication Tips
- ✓Approach from the front, use their preferred name, and make eye contact
- ✓Use short, simple sentences — one idea at a time
- ✓Allow plenty of time for responses — don't rush or finish their sentences
- ✓Validate feelings — acknowledge emotions even if the facts don't make sense
- ✓Use gestures, pointing, and visual cues alongside words
- ✓Never talk about the person as if they are not there
Further Reading
Important Notice
Care Handbook is a guidance resource only. It does not replace your organisation's policies, formal training, or current CQC standards. Always follow your employer's specific procedures and consult your line manager or the relevant professional body if you are unsure.