Imagine Being in a Country Where You Don’t Speak the Language

Imagine being in a country where the language is completely unfamiliar.

A visit to a restaurant suddenly becomes a different experience. The menu cannot be read, and the waiter speaks a language that is not understood.

Yet communication can still happen.

A finger points to a dish on the menu.

A smile shows appreciation.

A thumbs-up communicates satisfaction.

Gestures become clearer. Body language becomes more expressive. Tone of voice, facial expressions, and context all help carry meaning.

Even without shared language, communication continues.

The same principle applies in dementia care.

Understanding Non-Verbal Communication in Dementia

When verbal communication becomes difficult, many people living with dementia continue to communicate in other ways.

Facial expressions.

Body language.

Movements.

Actions.

Reactions.

Even silence.

This is known as non-verbal and para-verbal communication.

The challenge is not always that communication disappears, but that it requires a different way of listening.

Looking for the Message Behind the Behaviour

Is the person being difficult or cautious?

A person living with dementia may refuse assistance during transfers or support with daily activities. This can easily be interpreted as resistance. The person is "refusing" your help.

But what if there is more than meets the eye?

Having a fairly slight build, this is a situation that comes up from time to time. A person may initially refuse assistance when standing up or transferring from a chair to a bed.

When this happens, the person is not necessarily being difficult. They may simply be being cautious.

Perhaps they are worried about me getting injured. Perhaps they are worried about falling.

In those moments, repeatedly asking the person to stand up or insisting that they follow instructions is unlikely to help.

What often helps is acknowledging the concern and addressing it directly. Reassuring the person about your experience, your abilities, and your commitment to their safety can make all the difference.

The refusal was not about rejecting support.

It was about feeling safe.

Randomly undressing? Is it disinhibition or are they feeling too warm?

Another person may start randomly undressing.

Is it really random though?

What is the temperature like? Are they dressed appropriately based on the temperature and their level of activity? Could it be that they are simply too hot and undressing to cool down?

While it may look random at first, I can only invite you to go beyond that first glance, assume the person is communicating a need, and your role is to become curious about what that need might be.

At the start, this may feel difficult, with time, you'll start to learn their language.

who knows, these moments of curiosity may even start feeling like a fun challenge, one that feel rewarding when you've connected the dots. 

Communication Strategies for Dementia Care

When words become more difficult, communication can be supported in simple, practical ways.

• Observing body language and facial expressions
• Looking for meaning behind behaviour
• Simplifying questions when possible
• Using gestures, demonstrations, or visual cues
• Creating alternative ways to respond, such as tapping once for “yes”

These strategies are not about replacing conversation.

They are about making communication more accessible when speech is no longer the easiest option.

Learning a New Language

Communication does not have to end when words become difficult.

The need to express thoughts, emotions, preferences, fears, and needs remains.

What changes is the form it takes.

Dementia invites care partners to develop a different kind of listening.

Listening with the eyes.

Noticing patterns.

Remaining curious.

Paying attention to what is being communicated beyond words.

In many ways, supporting a person living with dementia can feel like learning a new language. And while that language may not rely heavily on speech, it can still carry meaning, connection, and understanding.

Conclusion

Communicating with a person living with dementia can become more challenging as the condition progresses.

By paying attention to non-verbal communication, adapting communication strategies, and remaining curious about what might be expressed, you can continue to build connection even when words become difficult.

Join the Conversation

What communication strategies have helped when words became more difficult?

Sharing experiences can support other care partners who are learning to navigate the same challenges.