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Communication Through the Stages of Dementia

Loss of communication skills follows a different pattern for different types of dementia and varies by individual. Here is a basic guideline of what communication difficulties to expect in the different stages of dementia:

Early dementia Some difficulty concentrating and following conversation; difficulty finding the right words when speaking or writing; losing train of thought when speaking; repeating oneself. Usually the person with dementia is aware of these problems and may try to hide or overcompensate for them.
Moderate or mid-stage dementia Difficulty following along with group and one-on-one conversations; losing train of thought when speaking; increased difficulty finding the right words when speaking or writing; loss of vocabulary, like proper nouns and slang terms; substituting words that sound the same or inventing new words; difficulty following storylines in books, TV shows, or movies; difficulty following directions; poor recall when telling others’ about recent events; increased used of gestures to communicate.
Severe or late-stage dementia Inability to follow along with anything other than simple conversations and instructions; increased loss of vocabulary, including personal information and loved ones’ names; inability to follow storylines in books, TV shows, or movies; tendency to talk about nothing, rambling, or babbling.
End-stage dementia Inability to speak or otherwise respond verbally; difficulty or inability to understand when spoken to; all communication may be done done non-verbally.