Talking and Listening


Peace: Acknowledge the Past as Present

Where there is confusion there can often be concern, conflict and distress. Sometimes in workshops, a person would ask after the whereabouts of a deceased relative (particularly a spouse) and when they were coming back. The natural response would be to correct and reassure – in other words to drag that person experiencing dementia back into the present. However this can, in turn, cause further distress and even build up resentment. We would avoid contradicting their current experience by acknowledging that, in that moment, the past for that person, was their present. We would, however, respond with as much reassurance as we could.

We might distract them with a statement, eg ‘Your husband worked as an architect’, encouraging them to talk more about their relative. This would sometimes be enough to move the conversation along a slightly different track. In Simeon’s Watch, Simeon struggles with questions. He is constantly being asked questions by Leah and responds in kind. This often leads to greater confusion and a lack of peace for both of them.


Practise the art of engaging in a conversation (with everyone!) without asking any questions. Avoid too much talking about yourself but, instead, work on contributing statements which ‘invite’ comment. This is harder than it sounds but your increased skill will come in very handy!

Playing Along

When people became confused during an activity – sometimes believing they were somewhere else – and where there was no distress, we might ‘play along’ as we would in ordinary improvisation. We discovered that children who had grand-parents with dementia are instinctively good at this and this ‘playful’ dialogue which is often filled with reassurance and laughter means that the quality of these relationships are often better, more peaceful. Our workshops and interviews with young people and their grandparents encouraged us to include this as a key plot element in our play, Simeon’s Watch.

Silence can be golden

We found that, by sharing an activity, we were still communicating. There was companionship and affirmation to be found sitting at a table and, for example, colouring together. Often this ‘silent’ time would unlock richer conversation or contributions after a long period of silence than if we had been interrupting it by asking questions.

Fishing (No Pressure)

It seemed to us that we are conditioned to converse with questions; ‘How are you feeling?’ or ‘What have you been up to?’ When someone is uncertain then even a friendly question can unsettle or produce anxiety. In our work we tried to practise a conversational style without using questions to take the pressure off. For example, instead of asking the question, ‘Isn’t the weather lovely?’ we might simply observe, ‘The sun has been shining all morning.’. If that did not produce a response we might ‘fish’ further, ‘I had to take my coat off.’ If nothing was still forthcoming we might continue on this new train of thought, ‘I bought it in Debenhams. It was very reasonable. I think it was in the sale.’ Each new statement is an opportunity for a contribution.

Sometimes we can get so stuck in asking fruitless questions that we leave no room for answers. ‘Would you like a cup of tea?’ is asked as the prepared cup of tea is brought out. ‘Would you like to watch some television?’ is asked as the T.V is switched on. This is the opposite of being present together.

So, we experimented with other ways of encouraging dialogue without asking questions. We called it ‘fishing’. That is, presenting an opportunity while taking the pressure off. Here are some strategies that seemed to work.

1. Smile. Direct eye contact with a smile often produces a reassuring space which the person may be encouraged to fill.

2. Wait. We can be afraid of silence but a pause (allowing the person time to process) is sometimes helpful. Keeping eye contact, a smile and a silence after a statement can be a very powerful conversation.

3. Be vulnerable. Sometimes allowing the other person to be the expert can generate dialogue. If the person was an excellent cook then making a statement about a particular culinary disaster might provoke some key advice. Often the carer’s role is one of authority but abandoning this role for a moment can lead to more relaxed conversation. Once, during a colouring activity, one of our workshop leaders noticed that the person he was working with kept pointing out the sections he had not yet coloured. Consequently, he would deliberately miss more sections out to encourage the person he was working with to help him more.

4. Offer. Sometimes we don’t need to speak at all in order to ‘fish’. Presenting an object (see above) might simply be enough. Share an experience together (listening to a piece of music, a trip outside, a sporting event) and this can lead to conversation – often about something barely related to the experience itself. It helps if this ‘offer’ breaks up the monotony of the usual routine and space.

5. Others. We regularly discovered that people who were quite far on in their dementia were more comfortable making contributions when the spotlight was not on them. In a two-way conversation, of course, this is impossible. In a group setting or even in a dialogue with three people there was space for the person to comment on what they were witnessing rather than participating directly. When our workshop leaders knew this they began to hold conversations which would invite comment from the sidelines while never asking the person themselves a direct question.

6. Affirmation. Any contribution would always be acknowledged and affirmed. The person could never say the ‘wrong’ thing. Even if the comment was rude or incorrect it seemed to us better to encourage the person in their participation.

7. Peace. This is easier said than done. We noticed in the practice of many carers and professional staff that an attitude of peace regardless of the distress or anxiety of the person often helped bring calm. It wasn’t so much what was said or not said but the calm, peaceful attitude (even when it was partly pretence) helped both the person and the carer.

8. Laugh. A little silliness goes a long way. We made sure there was as much comedy as we could muster in all our conversations. Often a comic atmosphere provided a perfect soil from which a conversation could grow. Laughter may not be a real medicine but it certainly helps.