Journal of Community & Public Health Nursing
Open Access

Understandably, caring for someone with dementia can be challenging as words often fail but love and understanding can still shine through. We just need to learn a new language, the language of the heart. As dementia affects memory and thinking which makes verbal communication difficult, reasoning, ability to present sound ideas and expressing self becomes difficult NHS UK and Alzheimer’s society are in support of this [1,2]. However, there is a need to comprehend that even when words are gone, emotions remain. These emotions are expressed through nonverbal cues. Body language, facial expression and tone of voice speaks volumes therefore learning to interpret these cues unlock a word of understanding, allows us to connect with the person on a deeper level. When we take the time to truly see and hear the person with dementia, we can begin to understand and honour their experiences. NHS UK 2023 and Alzheimer’s Society 2024 stressed the importance of communication, and that communication is not just talking but gestures, movement and facial expression are equally fundamental.

It is essential to show those with dementia that they are still valued and understood therefore, involving the individual in decision making where possible, embracing, and showing care and love to the person can make a positive difference and can promote a better communication/understanding channel for both the person with dementia and the caregiver [3,4]. This I think is the essence of compassionate care. Clearly it might be difficult to understand the person with dementia at first as acknowledged by Alzheimer’s Society [3], due to the new changes however, nonverbal communication is a skill that one can improve on if try according to Cherry K [5].

Deciphering the silent story

Body language is a powerful tool. A frown brow June signal pain or discomfort, a tight grip on a chair might indicate fear or anxiety while restlessness might suggest boredom or a need for stimulation. Facial expressions are equally telling. A smile or even flitting can express joy or contentment. A grimace might indicate pain or displeasure. Tears even without sobs can convey sadness or frustration. Observing tone of voice can add another layer of understanding. A sharp tone might signal anger or frustration. A soft tone of voice could be calming and reassuring. Even silent can speak volumes, indicating withdrawn or contemplation [6,7].

By paying close attention to these nonverbal cues and understanding and going back to the person first language as a child might also assist us to begin to master and decide the silent stories the people with dementia are trying to tell, which will then allow us to respond to their needs with empathy and compassion [8].

Familiar faces, familiar comfort

Those familiar to people with dementia play a crucial role. They share a history and a bound that transect the disease hence this familiarity provides comfort and security. Family and friends can often interpret nonverbal cues easily. They recognise subtle changes in behaviour. They understand the person unique way of communicating and their presence can calm and reassure the person with dementia. It can also trigger positive memories and emotions. Disconnection is invaluable. Involving familiar face in care is not just about practicality, it’s about love, connection and honouring the person lived live experience. It about reminding the person with dementia that they are loved and cherished. Alzheimer’s Project [9] stressed that maintaining the person familiarity is fundamental as it allows the person with dementia to feel comforted and calm which helps them to retain their sense of control and independence.

Patience, the bridge to understanding

Patience is paramount in dementia care and communication breakdown is inevitable. Frustration is understandable but patience is crucial. Therefore, we ought to learn to take a deep breath, approach the person with calmness and empathy. Avoiding interrupting or rushing them. Give them time to process information and respond. Listen with your heart, not just your ears. Pay attention to their nonverbal cues and try to understand the person perspective even when it’s difficult and remember that every interaction creates an opportunity for connection. Even small gesture of kindnesses can make a big difference [8].

Patience is a bridge to understanding and understanding is the foundation of compassionate care. ‘’For a care to be truly patient-centred, a foundation of compassion is essential’’ Frampton SB et al. [10].

1. NHS (2023) Communicating with someone with dementia - NHS (www.nhs.uk)
2. Alzheimer’s Society (2024) Communicating and dementia | Alzheimer's Society (alzheimers.org.uk)
3. Alzheimer’s Society (2024) Dementia and language | Alzheimer's Society (alzheimers.org.uk)
4. Understanding& caring for someone with dementia. dementia-booklet.pdf (firstpsychology.co.uk)
5. Cherry K (2022) 10 Tips to Improve Your Nonverbal Communication (verywellmind.com)
6. Budson E (2019) The Importance of Body Language in Dementia | Psychology Today
7. Alzheimer’s Society (2023) Communication, https://www.oxfordhealth.nhs.uk/wp-content/uploads/2023/02/Communicating-factsheet.pdf
8. Alzheimer’s Society (2024) How to communicate with a person with dementia | Alzheimer's Society (alzheimers.org.uk)
9. Alzheimer’s Project (2020) The Important of Routine and Familiarity to Persons with Dementia (2020) (alzheimersproject.org)
10. Frampton SB, Guastello S, Lepore M (2013) Compassion as the foundation of patient-centered care: the importance of compassion in action (becarispublishing.com)