The Signals That Matter: Body Language and Tone in Dementia Care

I remember being in a memory care community during a time of staffing challenges. We were all in the large dining room, residents eating dinner, when two staff members started discussing their frustration with the schedule and a coworker. As the conversation went on, their tone grew louder and more intense.

I felt a tap on my arm.

“Am I in trouble?” a resident asked, her eyes wide with worry. “Why is everyone so angry?”

Her concern was real, raw, and visible. I quickly asked the staff to take their conversation elsewhere. One of them looked puzzled. “Sure, but she has dementia. It’s not like she can understand what we’re saying.”

But in so many ways, she did understand.

When we think about communication, we often focus on words – the questions we ask, the stories we tell, the instructions we give. But for someone living with dementia, communication goes far beyond language. As dementia progresses, the ability to understand words can become more challenging, and our loved ones increasingly rely on nonverbal cues – the subtle signals we send through body language, tone of voice, and facial expression.

Sometimes the assumption is made that because the person living with dementia has short-term memory loss or is experiencing confusion, they don’t notice our stress, impatience, weariness, or frustration. In reality, the opposite is often true – they may be even more attuned to those emotions than we realize.

The Power of Nonverbal Communication

Even when words fail, people with dementia are often keenly aware of how we make them feel. They pick up on:

• Tone of voice: A gentle, calm tone can reassure and soothe, while a rushed or frustrated tone can cause anxiety or confusion.
  
• Facial expressions: A warm smile can invite connection, while a frown or tense expression may create tension, even if our words are kind.
  
• Body language: Leaning in to show attention, maintaining an open posture, or offering a supportive touch can communicate care far more effectively than words alone.
  

Our body speaks a language that resonates at a deep, almost instinctual level. People living with dementia subconsciously look for these cues to understand how safe, supported, and valued they are.

Why Words Alone Aren’t Enough

Imagine trying to follow a conversation while someone speaks in a calm, warm voice versus a hurried, distracted one. Even if the words are the same, the experience feels completely different. For someone with dementia, how we say something often matters far more than what we say. Words can lose meaning, but the emotions and actions we convey remain powerful guides for understanding.

Remember: We Are the Ones Who Need to Adapt

Sometimes, communicating effectively with someone living with dementia means adjusting ourselves. We may need to pause for patience, slow down, soften our tone, or use gestures to clarify what we mean. Although we have care tasks that are important, the ultimate goal in every interaction is that the individual feels safe, accepted, loved, and valued.

Practical Tips for Communicating Beyond Words

Here are strategies to help make every interaction more positive and meaningful:

1. Smile: It may seem simple, but a genuine smile conveys warmth, kindness, and reassurance.
   
2. Slow down: Speak at a gentle pace and pause to allow time for comprehension.
   
3. Maintain eye contact: It shows attention, interest, and respect.
   
4. Be mindful of your tone: Calm, reassuring voices help reduce anxiety.
   
5. Use supportive gestures: Open hands, a light touch on the hand, a hug when it is welcomed, or leaning slightly forward can communicate presence and empathy.
   
6. Mirror emotions carefully: A gentle nod of agreement or soft smile can reinforce comfort and connection.
   

The Heart of Connection

Ultimately, communicating with someone living with dementia isn’t just about transferring information – it’s about conveying love, patience, and understanding. When we pay attention to our own nonverbal cues and adapt to meet their needs, we can reduce frustration, enhance trust, and create moments of genuine connection.

AboutMary Stoinski

Mary Stoinski is the Executive Director of Dementia Life, a Missouri-based nonprofit dedicated to supporting seniors living with dementia and their caregivers. She is a certified Dementia Practitioner of Montessori for Dementia through the Association of Montessori International and has years of experience developing memory care training and programs in the corporate senior living sector. Mary has also served as a certified trainer for the Crisis Prevention Institute and as a community educator for the Alzheimer’s Association. She is deeply passionate about honoring and supporting seniors and the caregivers who walk alongside them.