General strategies to help make conversations easier

These can sound like common sense but putting them into practice can be challenging. 

The way that people respond to problems varies and often it's a trial-and-error approach to find the best one for the individual in a particular situation. 

  • make sure hearing aids and glasses are used if needed 
  • allow time 
  • find the best situation and place for conversing 
  • make sure you have the person's attention first 
  • non-verbal communication – posture, facial expression and tone can convey a lot to the person. Look at what the person does (their behaviour) as this is also a form of communication 
  • avoid long sentences and complex instructions if you can 
  • use simple, everyday vocabulary 
  • speak literally e.g. ‘that car was right on my tail' may cause confusion 
  • think about how you're going to say it before you say it 
  • use objects or pictures and show or demonstrate to help the person understand and follow what is being said 
  • avoid using he/she/it/there etc- it's better to repeat the name of the person, place or thing e.g. ‘Jack went to the dentist. Later that afternoon Jack [not he] met his daughter Sally at the bus station' 
  • avoid changing the subject frequently 
  • open-ended questions can be difficult e.g. ‘what would you like for tea?' Instead use a forced choice e.g. ‘fish or chicken?' or a ‘yes/no' choice, ‘would you like fish today?' 
  • in a large party, sitting in a quiet corner and inviting others to come and chat one at a time will be easier

Objects

If you use objects that the person can see, they are more likely to understand what is being talked about and are less likely to forget the topic. It can also help them to express an idea if they have difficulty finding the right word as they can show you instead. 

An object can also be stimulating to senses which can also help to encourage communication e.g. a flower – name – sight - colour – smell – touch. 

Word-finding difficulties

  • you may have noticed a specific difficulty with retrieving the correct words to say or holding onto an idea and remembering the topic 
  • more time is needed to find the word or to find an alternative way to say it; encourage ‘talking around’ a lost word e.g. ‘what does it look like?’ or ‘what do you use it for?’ 
  • you can help the person find the word through prompting but to pursue it all the time can interrupt the person too much and they may lose their train of thought 
  • if the person hesitates and loses the thread then prompt gently ‘you were telling me about…’ 
  • if the person selects the wrong word correct them quickly before this distracts them from what they were saying ‘did you mean…’ 
  • if the person can’t think of the word – if you know the ‘target’, then it usually reduces stress to tell the person the word – and it can help them to keep track of the idea they want to express 
  • if you don’t know the word try ‘narrowing the search down’ e.g. try and get the topic ‘is it about supper?’ or ‘is it about our holiday?‘ 
  • encouraging writing, pointing or gesturing may help the person to express their meaning 
  • if concentration problems prevent them responding to questions or comments then let them take the lead; you can follow by picking up key words - sometimes it can be a positive thing just to give the person your attention and repeat back the odd word or phrase for the experience of ‘a really good chat’ 

Repetition

The reasons for repetition can be memory loss but also a sense of uncertainty or anxiety of how to deal with a situation. 

Because of memory loss, the person may not remember asking or saying something previously so telling them they have just asked or said that will be confrontational. 

You could try: 

  • a short simple answer 
  • writing this down for the person to refer to 
  • a distraction task 
  • a calm non-committal reply e.g. ‘i’m not sure’
  • clarifying ‘validation’ of the feeling helps, e.g. ‘you seem worried you can’t remember…‘ 

Thinking and reasoning

Memory loss may result in muddled ideas and because of this people find it difficult to follow an argument or explanation or consider hypothetical situations. You may find that reasoned argument doesn’t always work and that it is better to defuse argument by distraction and avoid confrontation if possible. By experience you will discover that certain types of conversation work better than others. 

Sometimes people seem to get stuck on one subject and return to it even when the topic of conversation has moved on. It may be better to introduce an activity e.g. get up and walk about or have a cup of tea between conversations. 

References:

  • Chatter Matters Communication Training Pack, 2003 Colin Barnes 
  • Care to Communicate, 2000 Jenny Powell 
  • Making Conversation Easier, 2010 Marielle Kay and Lindsey Collins 
  • SLT Dept, Berkshire Healthcare 

To access more information about this resource and the service related to it, you can review the related resources below.

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