What to write to someone diagnosed with dementia? A guide to meaningful communication

According to the World Health Organization, over 55 million people worldwide live with dementia, a number projected to increase significantly in the coming decades. When a loved one receives this diagnosis, knowing what to write to someone diagnosed with dementia can feel overwhelming. This guide offers compassionate, practical advice to help you connect meaningfully through written words.

Quick Summary

Writing to a loved one with a dementia diagnosis should focus on simple, clear, and reassuring messages that express affection and shared memories. It is crucial to avoid correcting inaccuracies or testing recent memory to prevent frustration and maintain a positive emotional connection.

Key Points

• Prioritize Feelings Over Facts: When communicating, focus on the emotional connection rather than correcting inaccuracies or debating recent events.

• Keep it Simple: Use clear, simple language and short sentences to avoid overwhelming a person with dementia.

• Use Visuals: Incorporate old photographs or familiar images to trigger positive long-term memories.

• Reminisce About the Past: Discussing happy, distant memories can be a soothing and affirming activity for people with dementia.

• Offer Affection and Reassurance: Messages of love and support, combined with gentle physical touch, can provide immense comfort and security.

• Avoid Testing Memory: Refrain from asking questions about recent events or specific details that might cause frustration or embarrassment.

• Remember the Person: Treat the individual with respect and honor, acknowledging that their core identity remains, even as their cognitive abilities change.

Understanding the Impact of Dementia on Communication

Dementia is not just about memory loss; it affects cognitive functions like language, reasoning, and judgment. This means that traditional communication, based on factual recall and complex conversations, becomes increasingly difficult. For the individual, this can lead to feelings of frustration, anxiety, and confusion. For loved ones, the challenge lies in adapting communication styles to bridge this gap and maintain a connection that goes beyond words. Written communication, when done thoughtfully, can provide a tangible source of comfort and a way to share positive emotions without the pressure of a real-time conversation.

The Guiding Principles for Your Message

When you sit down to write, let compassion be your compass. Your goal is not to test their memory but to connect with their emotions. Here are the principles to guide your writing:

• Focus on Feelings, Not Facts: The person's current reality may be different from yours. Arguments or corrections about factual details are unproductive and cause distress. Acknowledge their feelings and respond with reassurance. If they are upset, address the feeling, not the inaccurate memory that triggered it.
• Keep it Simple and Clear: Use short, straightforward sentences. Avoid complex ideas or multiple instructions in a single sentence. If you are writing a card or letter, consider printing clearly rather than using cursive, which can be harder to read.
• Use Visuals: Memory is often connected to visual cues. Including a photo from a happy time in the past can trigger positive emotions and serve as a conversation starter if you're there with them. A picture of a beloved family pet or a favorite vacation spot can be very powerful.
• Reminisce on the Distant Past: While recent memories fade, long-term memories often remain clearer for longer. Writing about shared experiences from their childhood or your early relationship can be a source of joy and affirmation. This builds on their strengths, not their weaknesses.
• Offer Reassurance and Affection: Messages like “I love you,” “I’m thinking of you,” or “I’m here for you” are incredibly comforting. Physical touch, like holding a hand while they read, can also convey warmth and security.
• Accept Blame Gently: If they are upset about something, sometimes the most compassionate response is to accept the blame yourself, even if it's unfounded. For instance, if they can't find something, you can say, “I'm so sorry, I must have put it away and forgotten to tell you.” This de-escalates tension.

Practical Ideas for Written Communication

There are many forms your written message can take, from a short note to a longer letter or a personalized photo album. Consider these ideas:

• Short, Personalized Notes: Write a simple note and leave it where they will see it. “Thinking of you, love [your name].” These can be reread and serve as gentle reminders of connection.
• Holiday or Seasonal Cards: Use store-bought cards for special occasions or just to mark the changing seasons. These are often cherished and revisited. Write a short, encouraging message inside.
• Photo Cards: Find a photograph from the past—the “good old days”—and write about what you remember from that moment. Label the people and places clearly to help orient them.
• Journal of Memories: For a more involved project, create a memory journal filled with pictures, short anecdotes, and encouraging messages. This can be a wonderful resource for both the individual and their caregivers.

A Comparison of Communication Approaches

Feature	Effective Communication (Written)	Common Pitfalls (Written)
Tone	Calm, reassuring, and affectionate.	Anxious, demanding, or pitying.
Language	Simple words and short sentences.	Complex sentences or slang.
Focus	Feelings and long-term memories.	Facts and recent events.
Content	Reminders of affection, shared stories.	Quizzes about recent events or people.
Goal	Connect with emotions and affirm value.	Correct inaccuracies and test memory.

The Written Word as a Lasting Connection

Unlike a phone call, which can be forgotten within minutes, a written letter or card can be a gift that keeps on giving. A person can hold it, look at it, and have it read to them multiple times. This tangibility makes the message last longer, providing a consistent anchor of comfort and love. It serves as a physical reminder that they are not alone and that they are still loved and valued. This is profoundly important for someone who may feel increasingly isolated and unsure of their place in the world.

Conclusion: Your Presence is the Greatest Gift

Written communication is a powerful tool, but it's an extension of your presence. The most important thing you can offer is your love, patience, and acceptance. The written words are a vessel for that love, delivering reassurance and a connection to a past that brings them joy. By adapting your approach and focusing on the enduring person, you can continue to have a deeply meaningful relationship. For more guidance on supporting a loved one with dementia, consider reaching out to the Alzheimer's Association.

Frequently Asked Questions

How do I start a letter to someone diagnosed with dementia?

Start with a simple, warm greeting, like "Dear [Name]," and a reassuring opening line such as "I was just thinking of you and wanted to say hello." Focus on a positive emotion or a single, happy memory to set a comforting tone.

What kind of messages should I avoid writing to someone with dementia?

Avoid writing anything that could test their recent memory, such as "Do you remember what we did last week?" Also, steer clear of correcting factual errors or bringing up stressful topics.

Is it okay to send a letter with a photograph to a person with dementia?

Yes, including an old photograph is a great idea. Choose a happy memory and write a simple caption identifying the people and context. This can evoke positive emotions and help them connect with a cherished memory.

How can I make my writing easier for someone with dementia to read?

Use clear, dark text against a light background. Keep sentences and paragraphs short. Consider using bullet points and bolding important phrases. If possible, use larger font size to improve readability.

What if they don't seem to remember receiving my letter?

It is common for short-term memory to be affected. The value of your letter isn't just in the moment it is read, but in the positive feeling it creates. The letter or card can also be a physical object that offers comfort and can be re-read by them or a caregiver later.

Should I write about their diagnosis in the letter?

It is generally not recommended to bring up the diagnosis in a letter, as it can be upsetting. The focus of your writing should be on your continued love and support, not on their medical condition. Meet them where they are emotionally.

How do I address a difficult emotional response to my letter?

If your letter causes distress, address the emotion rather than the content. Acknowledge their feelings with reassurance, and gently redirect the conversation or activity. Remember that their feelings are real, even if the reason behind them is based on an altered reality.