Rethinking Communication guide to advanced dementia

21 Our expectations We have seen that dementia is accompanied by an obvious decline in the ability to communicate by the usual means: conversation. The distress that this causes for everyone involved reveals just how much we adults depend on speech to feel we are connecting with other human beings. As time goes by, a person who has dementia – someone we love very much or perhaps someone we’ve just met – may find themselves with only a handful of words left to use. Perhaps they can no longer speak at all. This reduced ability to talk is often misinterpreted by others as signifying that people with dementia have nothing to say or, more significantly, that they have lost the desire to communicate altogether. When we believe that, either consciously or unconsciously, then we act on it. We no longer try to engage either. We may feel disappointed and rejected because there is no longer an apparent wish to connect. We may feel relieved because there is no longer an implicit responsibility placed on us to try to keep doing something that