When we think of communication we may believe it is the same as language or speech. However, it is much more than that. Communication combines language, attitude, tone of voice, facial expressions and body language to pass on messages to others. Language on the other hand is a tool of communication. It may be written, spoken or expressed using gestures and body language. Speech involves using muscles to produce the sounds that make up language.
Communication is key for us; we use it to express ourselves, and to share our needs, desires, opinions, knowledge and feelings with each other. It allows us to connect with other people and maintain relationships. In different types of dementia, a person’s communication abilities can gradually decline as the disease progresses. This can lead to frustration and a decrease in quality of life.
There are many reasons why communication declines in people with dementia, and the extent to which and how it changes will depend on the type of dementia and stage of disease progression. Some of the factors that affect the ability of a person with dementia to communicate include:
The changes in communication that occur depend not only on the type of dementia, but also on the stage of the disease and the affected individual, as each person with dementia is unique. Below is a short summary of some of the most common changes that we can observe across different types of dementia:
Select the type of dementia below to find out more specific information about communication loss and relevant advice:
Alzheimer’s Disease (AD)
Frontotemporal Dementia (FTD), including behavioural variant and primary progressive aphasias
Parkinson’s Disease (PD)
Vascular Dementia (VD)
As mentioned above social conventions of conversations may be lost. This may result in the person with dementia talking too loudly, repeating ideas, speaking too much at inappropriate time or digressing from the topic.
Severe language decline can also mean that the person with dementia is no longer able to express their needs, which affects quality of life, prognosis and social relationship. For example, a person with dementia may find it difficult to maintain existing friendships, resulting in withdrawal from social contact.
At the same time activities of daily living that depend on communication abilities will be affected, which can result in a loss of autonomy, increasing caregiver burden.
Loss of communication is also associated with behavioural problems, such as agitation, restlessness and wandering.
It is important to bear in mind that communication is much more than just spoken language. In fact, research has shown that 55% of communication is conveyed through our body language, including facial expressions, posture and gestures. 38% is conveyed through the tone and pitch of our voice, and only 7% through the words we use. This means that how you say something may be much more important than the content of the message.
1. Encourage communication by starting conversations & making it easy to communicate:
2. Use body language & physical contact: Communication is more than just talking
3. Listen carefully & be aware of non-verbal messages, i.e. facial expressions & body language
This article is based on research publications and information from well-known organisations in the dementia space. Sources include:
Scientific Paper: The brain basis of language processing: from structure to function
Scientific Paper: Life with communication changes in Parkinson’s disease
Scientific Paper: The Language Profile of Behavioural Variant Frontotemporal Dementia
NHS guide: Communicating with someone with dementia
FCA guide: Communication (for dementia)
Alzheimer’s Association leaflet: Communication
Parkinson Society British Columbia leaflet: Communicating effectively with a Person with Parkinson’s who has cognitive impairments
Dementia Australia: Managing changes in communication