The Question-less Question: A Way to Engage a Person with Dementia in Conversation

One of the best things you can do to reduce the anxiety of a person with dementia is to not ask them questions. That is definitely easier said than done.  My mom had dementia and passed away last December. I did not live in the same state as my mom so a lot of my communication with her was over the phone. I wanted to know how she was, but I knew I couldn’t ask the question straight out. With my mom, if she sounded a bit down, I would start the conversation with, “I feel as if I am getting a cold,” in hopes of matching her energy and making a connection. If she wasn’t feeling well she would always respond with what was wrong with her. Her answers might be, “My stomach is not just right my head is feeling ‘squishy.’” (This usually meant the beginning sign of a stroke, as she had vascular dementia.) If she was feeling OK her responses would be more along the line of, “Oh that’s not fun.” Because I engaged her with a statement rather than a question, she could easily (and comfortably) form a response.

This is a person-centered approach, meaning it’s highly customized to each person, so it may take a few times to find just the right statement to get your question-less question answered.

Here are some common questions transformed into possible “question-less questions.” Remember, yours will be customized to the person you’re talking with.

Transforming Questions into Statements

How are you? You seem cheerful today!…or …You seem a little restless today….etc.
What’s the weather like out there? I’d heard it was supposed to be sunny today.
What would you like to eat? I was thinking of making a salad, and I thought you might like one too.
What did you do today? I see you have a puzzle started—you’re really making progress!
Where are you going? That looks important…I’d like to come too if that’s okay.
What is this? Well, this looks interesting…
What are you watching? This show looks good, but I don’t know much about it.
Do you have to use the bathroom? I was just going to use the bathroom, but trust me, you’re going to want to go first…
Are you tired? You look a little tired.
Did you hurt your arm? There’s a bump on your elbow. Let’s take a look at that…
Will you teach me about these trees? I wish I knew the names of some of these trees.

It was a hard thing to learn, but with practice, I’ve gotten pretty proficient at asking question-less questions when I’m working with people with dementia.

It helps to know a little something about the person. I knew that my mom loved talking about the weather. (It’s a Minnesota thing.) Instead of asking her how the weather was in Minnesota I would start with the weather here in Tucson. I’d just say, “It’s really hot here in Tucson.” By naming the city/state rather than saying “here” or “where I am,” this also relieves anxiety for the person with dementia as they do not have to go searching in their memory system for where you are talking about.

The method is simple: Give them short descriptive sentences to take in. This in itself reduced mom’s anxiety and allowed her to join in on the conversation with ease. As time went on, I realized what topics mom loved talking about and would only focus on those topics. That, along with not asking questions, not only reduced her anxiety but made her feel as if she was on top of her game, which boosted her self-esteem.

We would love to hear how other care givers found ways to reduce the anxiety of people with dementia!

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