You walk into the room and ask your mom if she wants tea. She looks at you, her eyes blank for a second, and then she says she needs to find her car keys. She hasn’t driven in five years. You correct her. "Mom, you don't have a car anymore, remember? We sold it. Do you want tea?" Now she’s angry. Now she’s crying. Now the whole afternoon is ruined.
This is the brick wall everyone hits.
When we talk about learning to speak Alzheimer’s, we aren't talking about a new vocabulary or some medical jargon you pick up from a pamphlet in a neurologist’s waiting room. We’re talking about an entire shift in how your brain processes reality. It’s a second language. It’s a language where logic is the enemy and emotion is the only syntax that actually works.
Most of us spend our lives obsessed with the truth. If someone says it’s Tuesday and it’s actually Thursday, we fix it. We think we’re being helpful. But in the world of dementia, "the truth" is a blunt instrument that just causes trauma.
Why Your Logic is Making Things Worse
Stop trying to win the argument. You won't.
Neurologically, the brain of someone with Alzheimer’s is physically shrinking. The hippocampus, the part responsible for forming new memories, is usually the first to take a hit. This means they literally cannot retain the fact that you told them five minutes ago that their sister passed away in 1994. When you "remind" them of that fact, you aren't just giving them information. You are forcing them to experience the fresh, raw grief of that death for the very first time. Every. Single. Day.
Experts like Naomi Feil, who developed Validation Therapy, argue that what the person is saying isn't "crazy"—it’s a reflection of an internal need. If a man with late-stage dementia is looking for his mother, he isn't necessarily confused about the year. He might just be feeling scared or lonely and is looking for the feeling of safety his mother provided.
Instead of saying, "Your mother is dead," you try, "You must really miss her. What was she like?"
That is the core of learning to speak Alzheimer’s. You stop being a fact-checker and start being a detective of the heart. Honestly, it’s exhausting. It feels like lying at first. But it isn't lying; it’s meeting them where they live.
The Habilitation Approach and the Power of the "Yes, And"
The Alzheimer’s Association often references the "Habilitation Therapy" model, which was pioneered by Paul Raia. It’s different from rehabilitation. You aren't trying to get the person back to where they were. You’re trying to make their current world work.
Think of it like improv comedy.
In improv, the golden rule is "Yes, and..." If your partner says you’re on the moon, you don't say, "No we aren't, we're in a basement in Chicago." You say, "Yes, and the gravity here is making my head spin!"
When you are learning to speak Alzheimer’s, you use this constantly.
- Them: "I need to go to work." (They retired in 1988).
- You: "You’ve always been such a hard worker. Tell me about your favorite job while we have lunch."
You’ve validated the feeling (I am a productive person) without reinforcing a stressful delusion or causing a fight. You’ve successfully redirected the energy. This isn't just a "trick." It’s a way to keep their cortisol levels down. High stress leads to "sundowning," that period in the late afternoon where agitation spikes and everything falls apart.
The Non-Verbal Dictionary
Did you know that up to 90% of our communication is non-verbal? This becomes a superpower when you're learning to speak Alzheimer’s.
As the left hemisphere of the brain (the logic and language side) degrades, the right hemisphere (the emotional and musical side) often stays intact longer. They can feel your frustration before you even open your mouth. If you’re sighing, crossing your arms, or wearing a "here we go again" expression, they will mirror that agitation.
Try this:
- Lower your center of gravity. Don't tower over them. Sit down.
- The "Hand-under-Hand" technique. Teepa Snow, one of the world’s leading dementia educators, advocates for this. Instead of grabbing their hand, place yours underneath theirs. It gives them a sense of control and connection rather than being "handled."
- Shorten the sentences. One idea per sentence. Max.
- Visual Cues. If it’s time to eat, show them the fork. Don't just say "It's dinner time."
Common Roadblocks and Real-World Friction
It’s easy for me to sit here and write about "validating feelings." It’s a lot harder when you’re on hour six of the same question.
"When are we going home?"
"When are we going home?"
"When are we going home?"
You’re human. You’re going to snap. And when you do, the "language" breaks.
One thing people get wrong is thinking they can "reason" someone out of a repetitive loop. You can't. Repetition is often a "broken record" in the brain—a neural circuit that’s stuck. Dr. Barry Reisberg’s Global Deterioration Scale shows us that in the middle stages, the person is essentially functioning at the cognitive level of a young child. You wouldn't explain the complexities of escrow to a toddler; you wouldn't use logic to stop a dementia loop either.
Distraction is your best friend. But it has to be a sensory distraction.
- "I’m not sure about the bus time, but can you help me smell this cinnamon? I think it’s gone bad."
- "Let's listen to that Frank Sinatra record while we wait."
Music is a back door into the brain. Research from the Institute for Music and Neurologic Function shows that rhythmic cues can bypass the damaged areas of the brain. Someone who can't form a sentence might be able to sing every word to "Amazing Grace." Use that.
The Ethics of "Therapeutic Fibbing"
There is a huge debate in the caregiving community about "therapeutic fibbing."
Some people feel like they are betraying their loved one by not telling the truth. It feels like gaslighting. But here’s the nuance: Gaslighting is meant to confuse and control someone for your benefit. Therapeutic fibbing is meant to soothe and protect someone for their benefit.
If your dad asks where his car is, and telling him it’s at the shop stops a three-hour panic attack, that is a kindness. Learning to speak Alzheimer’s is about recognizing that "subjective reality" is the only reality that matters in that moment.
If they are happy in 1965, let them stay in 1965. Why drag them back to 2026 if 2026 is full of doctors, pills, and a body that doesn't work?
Actionable Steps for Tomorrow Morning
You won't get this perfect tomorrow. You’ll forget. You’ll argue. That’s fine.
But if you want to start learning to speak Alzheimer’s effectively, start with these three adjustments:
- The Five-Second Rule: After you ask a question, count to five in your head. Their processing speed is slower than yours. Most people ask again after two seconds, which just resets the person's brain and starts the confusion over. Wait. Give them space to find the words.
- Eliminate "No" and "Don't": These words trigger a defensiveness. Instead of "Don't go out there," try "Let's stay in here where it's warm." Instead of "No, that's not your hat," try "That's a nice hat, but let's look at this one."
- The "Tell Me More" Pivot: Whenever they say something that is factually wrong or confusing, your default response should be "Tell me more about that." It buys you time to figure out the emotion behind the words, and it makes them feel heard.
The goal isn't a perfect conversation. The goal is a peaceful one.
When you stop trying to force them into your world and start stepping into theirs, the "behavioral issues" often just... melt away. Not because the Alzheimer's is gone, but because the conflict is. You’re finally speaking the same language.
Recommended Resources for Further Mastery
- "Positive Approach to Care" (Teepa Snow): Watch her videos on YouTube. She mimics the physical brain changes to show you why certain movements or words fail.
- "The 36-Hour Day" (Mace & Rabins): The literal bible of dementia care. It helps contextualize the "why" behind the "what."
- Validation Training Institute: If you want to dive deep into the Naomi Feil method of emotional connection.
Learning this language is a marathon. Take it one sentence at a time.