Dementia, sensory impairment and communicating

Hearing loss and dementia

Many people with dementia will have some kind of sensory impairment, such as sight loss, hearing loss, or both. This can cause them more difficulties with their communication. However, there is still a lot you can do to understand each other.

How a person with hearing loss communicates will depend on:

• the type of hearing loss they have
• whether they use a hearing aid, speak British Sign Language, lip-read or a use combination of these
• their personal preference and life history

People with hearing loss are likely to experience more difficulties as a result of their dementia. Not being able to hear what is going on around them or hear other people speak can add to their confusion.

Dementia and hearing loss can both make people feel socially isolated. This makes good communication even more important. 

Alzheimer’s Society has information in British Sign Language online. 

Tips for communicating with someone with dementia and hearing loss

These tips can help with communication with a person with dementia who has hearing loss.

• If the person uses a hearing aid, check that it is fitted and working properly. If you think the hearing aid isn’t working or if you need help checking it, speak to the GP. They may be able to make an appointment with the audiology department at your local hospital.
• Check if they have too much ear wax, as this may make any hearing loss and communication difficulties worse.
• Ask them if they would like to lip-read.
• Turn your face towards them and ensure your face is well-lit so your lip movements can be easily seen.
• Don’t shout or over-exaggerate words or lip movements. This can actually make it harder for them to understand you.
• Speak clearly and slightly slower, but keep the natural rhythms of your speech.
• Don’t cover your mouth.
• Consider using visual prompts, such as objects or pictures to help.

Sight loss and dementia

Some types of dementia can also cause problems with vision. People with sight loss are likely to experience more difficulties as a result of their dementia. Not being able to see what is around them can lead to a greater sense of disorientation. They may be less able to move and have a higher risk of falls. Having both dementia and sight loss can make people feel isolated, so good communication is even more important.

Communicating with a person with dementia and sight loss can be difficult. They may not be able to pick up on non-verbal cues or follow a conversation as easily. However, there are still a number of things you can do to help them.

Tips for communicating with a person with dementia and sight loss

• Check the person is wearing their glasses, if needed, and that these are clean and the prescription is up to date.
• If they have more than one pair of glasses, make sure they are clearly labelled for the activity they are used for – for example, reading glasses.
• Introduce yourself or get their attention before starting or ending a conversation. If you don’t, they may become confused about who is talking, or if they are being spoken to.
• If you are helping them with a task, let them know what you are going to do before and during it.
• Use reference points when describing where something is – for example, ‘Your water is on the table to your right’. You can also use imaginary hands on a clock face to describe where something is, especially for people who have lived with sight loss for many years – for example, ‘The cup is in front of you at 12 o’clock’.
• Make sure that the lighting is good and can be adjusted. Reduce shadows, as they may mistake them for obstacles.
• If you are communicating in writing, such as sending a letter or writing an email, think about the colour of the background and font size. Black text on a yellow background often makes text easier to read, as does larger text. If they have a mobile phone, you could change the settings with their permission to make text messages easier to read. 

Alzheimer’s Society has information and advice about dementia in audio format and on CD. You can listen online to this, as well as stories from other people affected by dementia.