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8 things you should never say to someone with Alzheimer’s disease, from the experts
More than 55 million people worldwide are currently living with Alzheimers and other dementias, according to the Alzheimers Associations 2024 report. Its impossible to overstate the impact it can have on the lives of those who live with it and the families who accommodate them. As there is no known cure, finding ways to prevent, slow, and better manage it is the best we can do for now. That starts with communication.
We spoke to three Alzheimers disease experts to understand what communicative strategies are best to employ when talking to someone with a neurodegenerative disease �it could be a family member or a friend. Collectively, they can offer a wealth of wisdom on what to say, what not to say, and what to bear in mind when making space for a dementia patient. So, whether or not you’re actively caring for someone, take note, as these may come in handy further down the line.
How to approach a conversation with someone who has a neurodegenerative disease
Socialization is vital for slowing the progress of dementia, says John Showalter of Linus Health.�
For people living with dementia, we need to make sure we meet them where they are, which can take patience and an understanding that they may not be oriented to the year or their surroundings.
It also takes time. People with dementia process information at a slower rate than they used to, and at a slower rate than those of us with healthy brains.�
John advises us not to ask for specific facts. If someone with Alzheimers dementia cant recall information, it can be frustrating and stop the dialogue. �
Instead, ask open-ended questions and questions that seek their feelings and opinions. Should they have difficulty sharing their thoughts, telling them about a positive shared memory is a good option.
Finally, John encourages people who arent daily visitors not to ask if the patient remembers us. It can be frustrating and embarrassing for them if they dont. Politely introduce yourself, he says, and gently re-orient with the important facts and let unimportant information go.
John Showalter is the chief strategy officer of Linus Health, a digital health company working on early detection of Alzheimers dementia and other forms of neurodegenerative disease. Hes a physician based in Danville, Pennsylvania.
4 general rules to follow when talking to someone with Alzheimers �the CART framework
Selina Huong Tran of Lisbet Memory Care draws attention to the CART framework of rules to follow when talking to someone with Alzheimers or dementia to keep them calm and feeling safe. �
Informal and professional caregivers are encouraged to follow the CART rules. Doing so can reduce the chances of triggering a behavioral outburst while providing care.�
CART is an acronym. It stands for:
- No Correcting: The resident is always right, Selina says. There is no reason to correct someone. You just ignore or go along with them.
- No Argument: Instead of arguing back, say things like, Youre right, Mom. What difference will it make to correct them? she asks.
- No Reason: Conditions like Alzheimers dementia shrink the brain by reducing the amount of active neurons. As a result, some adults may no longer have the capability to reason as they once did, so you just agree and move on.
- No Test: Asking questions that have concrete, right-or-wrong answers may feel like a helpful memory jogger, but not knowing the answers could be aggravating for someone with memory issues.
Following the CART framework, Selina says, helps residents with dementia feel that their caregivers accept them and validate their concerns.
Selina Huong Tran works at Lisbet Memory Care in Wellington Bay, Florida. She has worked with seniors in assisted living environments for over a decade and runs a monthly Alzheimers Support Group approved by the Alzheimers Association.
4 specific things you should not say to someone with Alzheimers disease
If youre looking for specific phrases you shouldnt say to someone with a neurodegenerative disorder like Alzheimers dementia, look no further. Christina Chartrand has a few short sentences she advises against using in conversation with a dementia patient.
- Dont you remember? Forcing someone to acknowledge their inability to remember something will only make them feel inadequate.
- Youre wrong This aligns with John Showalters advice above. She reiterates the point that its best not to try and argue or reason, and recommends saying sorry even if you have not done anything because it can de-escalate the situation.
- Good job or Let me help you Christina says we shouldnt condescend to dementia patients or talk to them as we would a child. They do not see themselves as children, and like everyone, want to be treated with kindness and respect.
Finally, she says, Do NOT lie to a person with dementia, as they could believe the lie and act on it. For example, if someone is asking after their late grandmother and you say, She went to the store, they might try to look for them.�
It is better to keep the focus on the moment, Christina says, and say, Tell me about your grandmother. Oh, she used to bake cookies with you? It is good to know their past and stories, so when they are going back in time where their older memories lie, you can help them in that moment.
Christina Chartrand is an educator and trainer. She has created numerous programs for families and caregivers, including Senior Gems, which is part of the Senior Helpers Alzheimers and Dementia Care program.
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