Dementia Communication Tips for Care Professionals

In dementia care, words carry deep emotional meaning. Even if you are using phrases that are intended to comfort or reassure them, it can sometimes trigger distress or confusion and it can also erode trust when not communicated properly. It can make care tasks harder for everyone involved. With these dementia communication tips, you can encourage cooperation and preserve the dignity, comfort, and emotional well-being of the people you support when used consistently.

According to the Alzheimer’s Association, it is common to have language and communication difficulties such as word retrieval, verbal comprehension, and expressive speech, across all dementia types. The person in front of you may already be exerting great effort simply to process and communicate their thoughts and feelings. That is why every word choice can either lighten that load or add to it.

Research by Kristine Williams at the University of Kansas identified that elderspeak significantly increases resistance to care. In videotaped care interactions, elderspeak was associated with a 55% probability of resistance, compared to 26% with normal adult communication.

The list below brings those findings into everyday care which can help caregivers communicate in ways that support trust and comfort.

20 Things Not to Say to Someone Living with Dementia

Some phrases that we are accustomed to use have negative neurological impacts on people living from dementia. Each item below will help you understand its impact and recommendations on what to do instead.

1. “You’re not making any sense.”

Even this short, fragmented speech carries heavy emotional content such as fear, confusion, and discomfort. Research on person-centered care in dementia consistently shows that feeling unheard or dismissed can affect their sense of dignity or safety.

What to do: Understand their feelings, instead of focusing on their words. Stay present, make eye contact, let the person feel seen, and give them a sense of assurance especially if you feel like they are not making any sense.

What to say instead: “It sounds like something is bothering you. I’m right here.”

2. “Remember, we’ve talked about this before.”

Short-term memory encoding is one of the first brain functions affected by dementia. Reminding someone they’ve forgotten a conversation can unintentionally reinforce feelings of frustration, shame, or humiliation as if they have only realized it for the first time.

What to do: Repeat the information calmly without signaling that it’s a repetition. Same warmth, every time.

What to say instead: “Your daughter’s coming this afternoon. She’s looking forward to seeing you.”

3. “You should know better.”

Saying this phrase implies that the person is intentionally ignoring information or acting inappropriately. Remember that dementia affects judgment, impulse regulation, and the ability to apply past learning to present situations. What you’re seeing is more often linked to cognitive and neurological changes than intent.

What to do: Offer simple guidance without blame. Phrase it in a way that you are providing a better solution without undermining them.

What to say instead: “Let’s try it this way.”

4. “Why can’t you just…?”

Saying this phrase implies that the problem is the person rather than the situation. A person living with dementia, has difficulty processing and sequencing different aspects of their lives. This makes it difficult for them to follow instructions.

What to do: Try a different approach, a different environment, or come back to it later. Use calm and supportive language to reduce pressure and offer guidance. Ask yourself what this person needs right now that they don’t have.

What to say instead: “Let’s try this together” or “Maybe we can do it another way.”

5. “That’s not how it happened.”

Memory distortion is a direct result of how dementia affects the hippocampus and its surrounding structures. It’s normal for them to recount fragmented, reordered, or blended older memories. Research on false memory in Alzheimer’s disease confirms that these inaccuracies are rooted in how dementia affects memory encoding and retrieval, rather than an intention to deceive.

What to do: Acknowledge the emotional truth. If the distorted memory is causing expressions of distress, gentle redirection works better than correction.

What to say instead: “That sounds like it was really important to you. Tell me more about that time.”

6. “You’re being difficult.”

Labeling a person by a behavior shuts down inquiry into what’s actually happening. In dementia care, what appears as “difficult” behavior is an expression of distress, often in response to fear, pain, and an unfamiliar threatening environment.

According to the Alzheimer Society of Canada, all behavior has meaning, and that meaning is usually an unmet need.

What to do: Ask what might be driving this response. Pain? Fatigue? Fear? An environment that’s too loud? Addressing the cause is more effective than managing the label. Use validating words that acknowledge their feelings.

What to say instead: “I’m here to help. Let’s figure this out together.”

7. “I’ve told you this already.”

When a person with dementia keeps on repeating a question, it is often driven by anxiety, disorientation, or something the person can’t express directly. UCLA Health notes that the recommended approach is to remove triggers and alleviate anxiety.

What to do: Respond with calm reassurance the same way each time, with the same tone, then look for the underlying need. If someone repeatedly asks when lunch is, they may be hungry. If they repeatedly ask when family is coming, they may need reassurance and connection.

What to say instead: “Lunch will be ready soon,” or “Your daughter is coming this afternoon.”

8. “You’re just trying to get attention.”

For someone living with dementia who may be experiencing confusion, loneliness, or pain they can’t articulate, reaching out repeatedly is communication. It signifies more of an unmet need that they cannot articulate clearly rather than attention seeking. Dismissing it can increase distress and can make them feel unsafe.

What to do: Sit with them for a moment and understand if there is a physical (e.g., hunger, pain, toileting) or emotional (fear or needing to feel included) need. Address what you find.

What to say instead: “You seem worried right now. Let me help you.”

9. “You should be over this by now.”

A research review on grief and loss in dementia found that people living with dementia continue to experience ongoing grief related to losses of memory, roles, and autonomy. The condition doesn’t remove the ability to feel those losses even in later stages.

What to do: Meet the person where they are. Acknowledge the loss.

What to say instead: “That sounds really hard,” “I can see this means a lot to you,” or “I’m here with you.”

10. “Stop being so confused.”

Confusion in dementia is a neurological state and not by lack of effort or attention. Telling someone to “stop” being confused can only increase fear and disorientation. Expressing your frustration aloud adds distress on top of confusion.

What to do: Reduce noise, simplify the space, and approach calmly. Use orienting language without pressure.

What to say instead: “You’re here at Maplewood. I’m Diane, your nurse. It’s Tuesday morning, and everything is okay.”

11. “You’re just not trying hard enough.”

People living with dementia often work extremely hard just to get through a task. During dressing, bathing, or meals, what looks like resistance is frequently the result of executive dysfunction, making sequencing difficult. Implying they could do better adds shame to an already effortful moment.

What to do: Break the task into small, manageable steps at a time. Demonstrate the action rather than describing it (show, don’t tell). Match your expectations to where the person is today.

What to say instead: “Let’s do this together,” “We can take it one step at a time,” or “You’re doing okay.”

12. “You’ll be fine, just forget about it.”

Telling a person with dementia to “forget about it” as casual advice dismisses the reality they are actively experiencing. It signals their feelings are inconvenient rather than valid.

What to do: First, acknowledge the person’s feelings before redirecting them. People respond better when they feel heard.

What to say instead: “I can see that’s weighing on you. Let’s sit for a minute.”

13. “Why can’t you do this like you used to?”

A PMC study on dementia and loss of practical skills identifies loss of practical skills and familiar roles as a recurring source of grief. Comparing their present abilities to the past can trigger shame and disengagement.

What to do: Focus on what the person can do now. If someone who used to cook independently can no longer manage the stove, they may still enjoy stirring, setting the table, or choosing the menu. Supporting participation, even in small ways, helps preserve dignity and purpose.

What to say instead: “Would you like to help with this part?” or “You’re really helping me by doing that.”

14. “I don’t have time for this.”

Care resistance rises significantly when communication signals impatience. When someone feels they are an inconvenience, expressions of distress increase, and the interaction ultimately takes more time.

What to do: If you need to step away, communicate it clearly and return when you say you will. This can help build trust and reduce fear.

What to say instead: “I need to finish something quickly, but I’ll come right back,” or “You’re important to me, and I’ll be with you soon.”

15. “You’re just being lazy.”

A longitudinal study of 662 people living with dementia found 51.7% met criteria for apathy, a recognized neuropsychiatric symptom distinct from laziness. Apathy increased over the disease course and was linked to faster cognitive decline and reduced daily function.

What to do: Before assuming disengagement, check whether the environment is overstimulating or the time of day is a factor. Apathy worsens for some people in the late afternoon or when fatigue sets in. Try a familiar, low-demand activity first. If the pattern persists, document it and bring it to a supervisor.

What to say instead: “Would you like to try this with me?” or “Maybe we can start with something small.”

16. “You don’t need help.”

People living with dementia often struggle to recognize or communicate when they need assistance, particularly when insight into their own limitations is inconsistent. Dismissing the need leaves them feeling unsupported or overwhelmed.

What to do: Pay attention to where the person gets stuck. Step in there, and let them lead everywhere else. Offering more help than needed removes dignity just as dismissing the need does.

What to say instead: “Would you like a hand with that?” or “I’m here if you need me.”

17. “I’ve told you a million times.”

People living with dementia can’t help but require repeated information. Hearing that their need for repetition is exhausting sends a clear message about their worth in the interaction.

What to do: Answer patiently, every time. If someone keeps asking about an upcoming appointment or a family visit, a written note or a familiar object they can hold may reduce the frequency more than repeated verbal answers.

What to say instead: “Your daughter is visiting later today,” or “Your appointment is tomorrow morning.”

18. “You’re just making things up.”

Confabulation (filling memory gaps with inaccurate content that feels real to them) is a recognized symptom in several dementia types. The person isn’t lying; their brain is generating content to fill what it can’t retrieve.

What to do: Respond to the emotional content rather than the factual accuracy. If someone insists a deceased family member is coming to visit, asking what that relationship meant to them honors the feeling without confirming the belief. If the pattern is new or has changed, document it since new confabulation can signal disease progression or an acute medical change.

What to say instead: “You really miss them,” or “Tell me more about that.”

19. “I can’t believe you don’t remember that.”

Expressing disbelief at a person’s memory loss reinforces shame. It also signals that you haven’t fully absorbed the basic nature of the condition, which erodes trust in the interaction.

What to do: Treat memory lapses as an expected part of this condition. Gently provide the information the person needs and move forward with warmth.

What to say instead: “Your grandson visited yesterday.”

20. “You’re too old for that.”

Research on autonomy in residential dementia care found that treating loss of independence as loss of all meaningful choice results in limited self-expression and causes measurable harm. A wish to go somewhere or see someone is still worth taking seriously.

What to do: Honor it where you can and address what is underneath the request.

What to say instead: “Let’s see how we can make that work,”

Person-Centered Dementia Communication Strategies

The 20 phrases above cause harm because they pull against a common set of underlying principles. Understanding those principles helps you find the right words naturally.

Person-first language and preferred names

“A person living with dementia” rather than “a dementia patient” is a small shift that signals the diagnosis does not define the person.

Use the person’s preferred name, title, or pronouns. Ask the person and their family how they prefer to be addressed, and document it.

For someone experiencing memory loss or confusion, hearing their own name used consistently can be genuinely orienting.

Empathy, patience, and flexibility

Stay curious about what the person is experiencing beyond what they’re saying.

Give them time to process and respond. Cognitive slowing is neurological, and pushing past it rarely helps.

What worked this morning may not work this afternoon, so adjusting your approach is part of the skill.

Non-verbal communication

Your posture, tone, eye contact, and proximity often land before words do. It’s the primary care necessary for people living with reduced verbal comprehension. A calm body, a steady tone, and a genuine expression communicate safety in ways that words alone can’t always reach.

Validating feelings

Validation approaches are widely used in dementia care and supported in several communication-focused studies. A 2024 study published in PubMed found that affirming the person, acknowledging their emotions, and verbalizing understanding led to cooperative responses during care activities, and that withdrawing those techniques led to resistance.

Acknowledge the feeling behind what a person says instead of correcting it. “That sounds like it’s weighing on you. Tell me more” does more than any correction.

Avoiding patronizing communication

A sigh, an eye roll, turning away mid-sentence, and other dismissive non-verbal behavior registers just as clearly as patronizing words. The same goes for talking about the person to a colleague as if they’re not in the room.

Use clear, adult-appropriate language, introduce yourself every time, and offer choices wherever possible. “Would you like to start with breakfast or get dressed first?” gives the person agency that a single instruction doesn’t.

Trauma-informed and culturally sensitive care

Many older adults have lived through significant trauma (war, displacement, abuse, or loss), and for people living with dementia, those memories can resurface unpredictably. If you notice sudden expressions of distress during a routine care task, consider whether a past experience may be a factor before assuming it’s a reaction to the task itself.

Review life history documentation, talk with family members, and observe patterns over time. If distress expressions are consistent during specific routines or with specific staff, adjust the approach accordingly.

Cultural background shapes communication just as much. Norms around touch, eye contact, personal space, and formality vary significantly. Avoid assumptions about how a person’s culture, language, religion, and other preferences shape their communication style. When language barriers exist, involve professional interpreters.

Communication in later stages

As dementia progresses, verbal expression often becomes significantly reduced, but the person won’t stop communicating.

Research published in The Gerontologist found that people with advanced dementia continued to express themselves through facial expressions, vocalizations, gestures, and body movement. Moreover, music-based interaction supported non-verbal communication and connection in ways verbal approaches could not.

At later stages, your presence is the primary tool. Keep your movements at a slow pace, make eye contact at the person’s level, keep a gentle tone, and don’t underestimate what a warm hand held without rushing can do.

Frequently Asked Questions About Dementia Communication

Why do people living with dementia repeat questions?

Repetitive questioning is often driven by anxiety, disorientation, difficulty retaining new information, or an unmet need they can’t put into words. Answer each time calmly and look for the underlying cause. Hunger, fear, loneliness, or overstimulation are common drivers. Changing the environment or offering a reassuring activity often helps more than redirecting the question.

Is it okay to go along with something a person living with dementia says that isn’t true?

Yes, in most cases. This is the basis of validation therapy, developed by Naomi Feil and widely supported in dementia care research. When a person says something that’s emotionally true to them, even if factually inaccurate, correcting them rarely helps and often causes distress.

Responding to the emotional content (“You really miss her, don’t you?”) is kinder and usually more effective. But if what a person believes is putting them or someone else at risk, document it and raise it with a supervisor.

What is elderspeak in dementia care?

Elderspeak uses a sing-song tone, overly simplified vocabulary, and collective pronouns (“Are we ready for our bath?“) – a register that treats the person as a child. Simplified communication uses short sentences, clear words, and a normal adult tone. The difference is in the respect embedded in the delivery. Research shows that elderspeak nearly doubles the probability of resistance to care. Instead, use simplified adult communication and deliver it with respect.

What should I do if I have already said something unhelpful?

Pause and lower your energy. You don’t need to apologize at length. Just shift, “Let me try that differently.” If things have escalated, step away briefly, let the intensity settle, and come back with a different approach.

Why do people living with dementia struggle to find the right words?

Word-finding difficulties are a common and early sign of most dementia types. The brain’s ability to retrieve and sequence language is affected by the same neurological changes that impact memory and reasoning. Finishing someone’s sentence or rushing past a pause can cut off the connection before it has a chance to form. Use simple, unhurried communication instead.

Strengthen Your Dementia Communication Skills

Knowing what not to say is only part of effective dementia communication. It’s more important to master the skill of learning how to adapt in unpredictable moments, especially when distress escalates or language breaks down.

The 20 phrases in this guide and the principles behind them give you a practical foundation. However, continuing education helps you move beyond knowing what not to say to understanding why people living with dementia respond the way they do, and how to adjust in the moments that don’t follow a script.

The National Council of Certified Dementia Practitioners (NCCDP) offers the Certified Dementia Practitioner (CDP®) credential, a nationally recognized certification built specifically for people doing this work. It covers dementia communication, person-centered care, and practical care strategies you can use across settings.

Take the next step toward CDP® certification.