Conversation starters for someone with dementia

Why can conversation feel hard?

Dementia can make it harder to find words, follow a fast conversation or answer a question on the spot. Many visitors respond by asking more questions, which can make it harder still. Alzheimer's Society notes that asking too many questions, or complicated ones, can feel tiring. A few small changes in how you start a conversation can make visits easier and more enjoyable for both of you.

How do you start a conversation with someone with dementia?

• Get the setting right. Sit where they can see and hear you, ideally at eye level. Turn off the television or radio first: Alzheimer's Society notes that communication works best in quiet, calm places with good lighting.
• Say who you are in a natural way, without testing them: "Hello Mum, it's Sarah. I've brought you some flowers from the garden."
• Start with a comment, not a question. "That's a lovely cardigan. Blue always suits you" invites a reply without demanding one.
• Use something to look at or hold. A photo, a page of their life story book, a newspaper, a flower. Pointing at something shared takes the pressure off.
• Speak clearly and slowly, in short sentences, as the NHS suggests, and keep your tone warm and friendly.
• Give time. The NHS advises giving people time to respond, because they may feel pressured if you try to speed up their answers.

What are good conversation starters?

These openers work because they share something rather than test something. Adapt them to the person: the names, places and details you know are what make them work.

About the here and now

• "It's a bright morning. The sun's on the garden."
• "Your tea's just how you like it: milky, one sugar."
• "The robin's back on the bird table."
• "I brought you some of those biscuits you like."

About photos and objects

• "This is you and Dad on your wedding day. What a dress."
• "Here's your old bus depot badge. You looked so smart in that uniform."
• "I found this postcard from Scarborough in the drawer."

About growing up and family

• "I was telling the children about the bakery you grew up above."
• "Auntie Jean sends her love. She said you two always laughed in church."
• "Tom's started at the school you went to."

About work and skills

• "I tried to make your Yorkshire puddings. They didn't rise like yours."
• "Someone at work asked me about knitting. I said my mum's the expert."
• "There's a match on Saturday. United are playing at home."

About music and pastimes

• "I've put some Matt Monro on. You always sang along to this one."
• "The roses you planted are out again."
• "I've brought the crossword. You're better at these than me."

If they respond, follow wherever they go. If they don't, that's fine: sitting together, holding a hand, or listening to music is still a good visit.

Which questions work better?

Questions aren't banned; some are just easier to answer than others. Alzheimer's Society suggests not asking too many open questions, and giving choices, but not too many options. The NHS suggests giving simple choices and rephrasing a question if it isn't working.

When you're gathering material for a life story book, you'll want deeper questions; our life story questions are organised by chapter and include tips for asking them gently.

What should you avoid saying?

• "Do you remember…?" It can feel like a test. Alzheimer's Society suggests avoiding trying to jog someone's memory, and speaking about the things you remember from the past instead.
• Correcting small mistakes. If they think it's Tuesday or call you by your aunt's name, ask yourself whether it matters. Alzheimer's Society's advice is to think about whether it is necessary to correct someone's beliefs: if they're not causing harm or anxiety, you may not need to.
• Talking about them as if they aren't there. Include them in conversations, and let them speak for themselves where they can, as the NHS suggests.
• "Elderspeak". Alzheimer's Society warns against a high-pitched, sing-song voice. Speak to them as the adult they are.
• Rushing. Let them finish their own sentences without interrupting, even if you think you know what they're going to say.

What if they find words very hard?

Conversation isn't only words. The NHS suggests patting or holding the person's hand while talking to reassure them, and keeping your tone positive and friendly. Alzheimer's Society describes eye contact and nodding as non-verbal encouragement. Laughing together about misunderstandings, as long as they don't feel laughed at, can bring you closer too.

• Watch their face and body for what they're feeling, and respond to the feeling rather than the words.
• Hum or sing a song they know. Some people who find talking hard still enjoy joining in with a familiar song.
• Look through a book or photos together without needing to talk much at all.

What about phone and video calls?

Calls can be harder than visits because there are no faces or objects to point at. A few things help:

• Keep calls short and at a regular time of day.
• Say who you are straight away, and use your name again during the call.
• Ask a carer or relative to hold up a photo or the life story book at their end, so you have something to talk about together.
• On a video call, sit somewhere well lit and quiet, and don't worry if they talk to the screen rather than to you.

How can a life story book help conversation?

A life story book gives every visitor something to say. Each page has one large photo and a short caption in the person's own voice, so a grandchild or a new care worker can open it anywhere and start: "You grew up above a bakery? Tell me about the smell of the bread." Our guide to reminiscence activities has more ways to use it, and a memory box of objects works well alongside it.

If you'd like a printed book the whole family can help with, Still Me lets relatives add photos and memories through one link and posts a wipe-clean book with a one-page "About me" sheet that tells carers what they enjoy talking about.