How to Communicate with Alzheimer’s: Decoding Words & Behaviors

• Approach & tone: Eye level, gentle smile, slow voice, open hands.

• One step at a time: “Let’s stand up.” (pause) “Now we’ll walk to the chair.”

• Two choices only: “Blue or green sweater?” (both acceptable)

• Validate the feeling: “That sounds frustrating. I’m on your side.”

• Redirect with purpose: “Can you help me set the table?”

• Environment reset: Lower TV, soften lights, reduce clutter.

Early Stage (Mild): Collaborate & Cue

What changes: Word-finding trouble, losing the thread in conversations, fatigue in noisy places.

Try this

• Ask, don’t quiz. Use open prompts: “Tell me about your morning,” rather than testing memory.

• Cue discreetly. Provide a word, a name, or the first letter: “It’s your cousin, M—, Maria.”

• Agree on supports. Big-label calendar/whiteboard, pill organizer, photo-labeled contacts.

• Activity fits energy. Short visits, quiet cafés, small groups, clear agendas.

Helpful scripts

• “Take your time—I’m listening.”

• “Would notes help, or should I text you the plan?”

• “Let’s write it on the whiteboard so it’s easy later.”

Middle Stage (Moderate): Simplify & Reassure

What changes: More repetition, mixing up words, difficulty following multi-step directions, rising anxiety or “sundowning.”

Try this

• Short sentences + gestures. Point to items, model actions.

• Break tasks into steps. “Wash hands,” then “dry hands,” then “comb hair.”

• Two-choice offers. “Sweater or shawl?” “Tea or water?”

• Sundowning buffer (late afternoon). Lights on before dusk, curtains closed, calm music, simple task (sorting, folding), early light dinner.

Helpful scripts

• “You’re safe. Let’s sit a minute and have tea.”

• “That sounds upsetting. We’ll fix it together.”

• “First socks, then shoes. Great—we did it.”

Late Stage (Advanced): Connect Beyond Words

What changes: Few words or none, more nonverbal communication, sensitivity to touch/tone.

Try this

• Sensory connection. Familiar music, hand massage with lotion, soft blanket, favorite aromas (if tolerated).

• Yes/no questions with time to answer. Watch eyes and facial cues.

• Comfort position & pacing. Slow care, warm hands, narrate each step.

Helpful scripts

• “I’m here. You’re safe.”

• “Warm water on your hands now.”

• “Let’s listen to your favorite song together.”

• Use names/roles: “Mary, it’s John—your son.”

• Offer praise for effort, not accuracy: “You did great.”

• Match their rhythm: slow pace, longer pauses.

• Argue facts or correct repeatedly.

• Ask “Do you remember…?” (feels like a test)

• Crowd or corner—keep an exit path and personal space.

1. Breathe; lower your voice and your pace.

2. Validate: “I can see this is upsetting.”

3. Two choices (both acceptable).

4. Change the setting: lower lights/TV, move to a quieter spot.

5. Redirect with purpose (folding, watering plants, looking at photos).

6. If stuck, pause and try again in 5–10 minutes.

• Big-label room/drawer signs; a whiteboard with “Today’s Plan.”

• Photo books and a short morning/evening playlist.

• Motion nightlights for bathroom routes; door chimes if wandering risk.

• ID bracelet; pill organizer; a go-bag (med list, insurance, directives, contacts).