Communicating with someone who has dementia is generally a catch-as-catch-can undertaking. Because the disease is progressive what works today may not work tomorrow. And what hasn't worked may suddenly be useful again as the patient has a better day.

We have many ways of communicating. Speech is only one of several ways we communicate. We also have touch, sight, smell, hearing and movement.

Art is a good outlet for some dementia patients in the early to middle stages of Alzheimer's or other dementia. If the person you are working with enjoys painting, manipulating clay, or stringing beads these are good activities. If the person never enjoyed these kinds of activities, or if they are frustrating now, then they will not be beneficial.

Other activities might be looking at photographs together, listening to music and singing along (people with speech difficulties can often sing the lyrics to songs from the past even when they cannot speak coherent sentences). Simply holding hands while taking a walk through the neighborhood or through the house can be a form of communication.

The most important thing to remember is that we must adapt our way of communicating to the abilities of our loved ones. We cannot force them into our way. Often people with dementia will communicate through their behavior. It is difficult, but it is our job to try to figure out what is being communicated. Often we fail, but we continue to make the attempt. Reassurance that they are loved and appreciated is very important.

There have been many studies that confirm the needs of our loved ones to feel that their abilities are respected, even if they cannot communicate verbally with us. Unfortunately, there is no study I know of that demonstrates exactly how to communicate with the cognitive difficulties of Alzheimer's or the other dementias. This is because these diseases affect each person differently. What may work for one will never work for all.