I am amazed at the number of conversations I have in a day, where I have no idea what we are talking about.
When you are talking with someone with dementia, the conversation can take all kinds of twists and turns. It may go down dark alleys where you don't recognize anything. You may get totally lost. This happens to me several times in a day.
I want to give you my primer on what you don't do, and what you do in these kinds of situations. Both are important. The goal of a conversation with someone with dementia is for both of you to come away satisfied, and to feel like you have communicated. This is possible, even if the words don't make any sense.
1. Don't argue. It accomplishes nothing (except perhaps making you both frustrated and angry) and the person with dementia will be convinced you are wrong, anyway.
2. Don't laugh. You may hear some of the most outlandish things, but it's important that the person feels respected and not made fun of. Watch your body language! (More on this later,) Of course, if the person says something funny that was designed to make you laugh, or you're laughing together, that's another story.
3. Don't give up. Communication isn't all about the words that are spoken. If you don't understand, look for other signals that give a hint as to the person's mood. Are they angry, upset, happy, frightened? Go with what you can pick up, and address it. "George, I'm not totally understanding, but you seem unhappy." You may never "get" what the conversation was about, but if you and George go away from it having communicated, that's all that matters.
4. Do take the blame for the lack of communication. George knows what he means, but you have an understanding problem. Validate him by your attitude. It's not, "George, what are you talking about?"
but "George, I'm not sure what that means. Could you help me understand?"
5. Do treat the person with respect.
6. Do watch body language, which speaks clearer than words. What is the facial expression? Do they look animated or depressed or thrilled or agitated? Even if none of the words spoken make sense, this will give you huge clues, and you can address it.
7. Do use your own body language to communicate. A smile, a hand on an arm, a hug--all of these can help a person feel that they have been heard. I try to look interested, nod my head, say "uh-huh" and nod some more. I give my full attention, even if the words make no sense to me.
8. Do try to pick up the thread. There may be something--a few words or an expression, that you understand and can pick up on.
Communication is about being heard. If, after a conversation, the person with dementia feels they had your full attention, they received respect and empathy and were heard, they will be satisfied.
Words are secondary.