People with dementia have difficulties communicating for a number of reasons.

Find out about the patient's ability to communicate when they first come into hospital. Family and carers help. Once established, communication strategies that work should be shared with the whole multidisciplinary team at handover so others can use them.

Problems with understanding
Some have problems with understanding what they hear or cannot find the words for what they want to say or they might take longer to process the information and come back with an answer.

Problems with memory
People with dementia can forget what the conversation is about or not know the answers to questions. They can often say how they feel now, but for information on past symptoms we need to ask family or other carers.

Disorientation to time and place
Some patients with dementia are disorientated in time and place, or experiencing delusions or hallucinations. These can cause misinterpretation of what is being said or the behaviours of staff.

Problems with hearing, speech and vision
Older people often have problems with hearing. They may also have problems with speech or vision, for example, because of missing dentures, a previous stroke or poor vision.

English as a second language
People with English as a second language may lose their ability to speak in English whilst retaining ability in their first language. Interpreters may be needed.