When my friend Joan (a pseudonym) moved to an assisted living community because of her moderate dementia, many of her friends fell away. If asked why they no longer called or visited, they often answered that they didn’t know what to say to her or were afraid of saying the wrong thing, as if she had turned into a creature from another planet. That’s a loss for everyone.

When talking with someone with dementia, begin by assuming you can carry on a conversation as you always have, but perhaps more slowly, as it can take time for the person to “tune in” to what you are saying. Beyond that, many difficulties can be overcome with two rules:

1) Go with the flow. Recently Joan tried to share an incident in which a beloved grandson was treated unfairly in her mind, spoiling a planned family outing. Joan was clearly upset by it but could not coherently explain what happened. When I later learned the facts from Joan’s daughter, it was a minor incident, but because it was clearly important to Joan, our little group at the time treated it as such. She did not need us to be clear on the details she couldn’t provide. She did need us to affirm her sense of injustice and commiserate: “I’m sorry to hear that. . . It must have been upsetting. . . How unfair!”

2) Distract. A few months before she moved into her assisted living apartment, Joan’s beloved, long-lived dog died. Although she is no longer capable of caring for a dog, owning one again is never far from her mind, especially because others in her residential care home have pets. When Joan brings it up, so far I have had success distracting her with long ago memories of a dog she owned as a child (rather than the one that recently died), debating whether owners really do look like their dogs (sharing Internet pictures), and the funny names pet owners choose – the last of which can lead away from dogs into appropriate (or not) names for cats, birds, horses, and llamas.

If you have a question or additional advice, please contact me at Kathy@WiserNow.com.