Alzheimer’s disease can make communication difficult for both caregivers and the person with Alzheimer’s. This page covers how Alzheimer’s can change how a person communicates and provides tips for how to manage these changes.

How does Alzheimer’s change communication?

People with Alzheimer’s may struggle with:

• Finding the right word when speaking
• Understanding what words mean
• Paying attention during long conversations
• Organizing words logically
• Keeping their train of thought when talking
• Blocking out background noises from the radio, TV, phone calls, or conversations in the room

Alzheimer’s causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, they might understand and use only their first language, such as Spanish.

Tips to cope with communication challenges

Keep the following suggestions in mind to make communication easier:

• Make eye contact and call the person by name.
• Be aware of your tone, volume, facial expressions, and body language. Try to avoid appearing angry or tense. Show a warm, loving, and matter-of-fact manner.
• Encourage a two-way conversation if the person is able.
• Be open to the person’s concerns, even if they are hard to understand or address.
• Be patient with angry outbursts. Try a distraction, such as offering a favorite snack or a walk outside. If you become frustrated, take some time to calm down.
• Allow more time for the person to respond. Be patient and try not to interrupt.
• Don’t talk about the person as if they are not there.
• Don’t talk to the person using “baby talk” or a “baby voice.”
• Use methods other than speaking to help the person, such as gentle touching to guide them. Hold the person’s hand while you talk.

When speaking to a person with Alzheimer’s, try to ask questions with a yes or no answer, and if the person does not understand what you say the first time, try rephrasing what you said with different words.

Here are some examples of how to change what you say to the person with Alzheimer’s to make communication easier:

Avoid saying	Say this instead
What do you want for dinner?	Do you want fish or chicken for dinner?
That’s not how you do it.	Let’s try it this way.
How do you feel?	Are you feeling sad?
Are you hungry?	Dinner will be ready in five minutes.

Be aware of nonverbal communication. As people lose the ability to talk clearly, they may rely on other ways to communicate their thoughts and feelings. For example, their facial expressions may show sadness, anger, or frustration.

To learn more, please visit https://www.nia.nih.gov/health/alzheimers-changes-behavior-and-communication/communicating-someone-who-has-alzheimers.

The winter season can be a challenging time to stay active, with colder temperatures, slippery conditions, and fewer daylight hours. But staying physically active is one of the best ways to improve your mental and physical health and keep on track with your fitness goals. Physical activity can help you sleep better and reduce anxiety. Regular physical activity also helps:

• Improve your balance.
• Lower your risk of type 2 diabetes and many kinds of cancer.
• Strengthen bones and muscles.
• Lower blood pressure.
• Maintain or lose weight.
• Keep your mind sharp as you get older.

Emerging research also suggests physical activity may help boost your immune function.

Experts recommend that adults get at least 150 minutes of moderate-intensity physical activity a week. Many activities count, such as walking, running, or wheelchair rolling. You can break that up into smaller amounts, such as 22 minutes daily, 30 minutes on 5 days a week, or what works for your schedule. It all counts.

Six tips to stay active during winter

1. Take nature walks – Weather permitting, schedule time during the day to enjoy nature. Take a stroll around a safe neighborhood or park.
2. Monitor the weather and plan ahead – Weather forecasts give several days’ notice to prepare your week. Be sure to monitor the weather, dress appropriately, and plan your winter activity accordingly.
3. Wear layers – Wear several layers of comfortable clothing so that items can be removed easily as you become warmer. Layers will help guard against overheating, sweating, and eventually becoming colder.
4. Workout online – Consider tuning into a TV, online, live Zoom, or Instagram workout class. Find free or low-cost exercise videos online to help you do aerobics, dance, stretch, and build strength.
5. Do some chores –  When bad weather keeps you from going outside, look for ways to be physically active indoors. Housework such as vacuuming, sweeping, and cleaning all count towards your physical activity goals. And you’ll knock out some items on your to-do list while gaining health benefits. Walking or running up and down stairs in your home can be a great workout, too.
6. Volunteer in active ways – Help others while helping yourself. Look for volunteer opportunities that involve physical activity, such as walking dogs for elderly neighbors or shoveling snow.

To learn more, please visit https://www.cdc.gov/physical-activity/features/stay-active-this-winter.html

Older adults need about the same amount of sleep as all adults—7 to 9 hours each night. But, older people tend to go to sleep earlier and get up earlier than they did when they were younger.

There are many reasons why older people may not get enough sleep at night. Feeling sick or being in pain can make it hard to sleep. Some medicines can keep you awake. No matter the reason, if you don’t get a good night’s sleep, the next day you may:

• Be irritable
• Have memory problems or be forgetful
• Feel depressed
• Have more falls or accidents

Get a Good Night’s Sleep

Being older doesn’t mean you have to be tired all the time. You can do many things to help you get a good night’s sleep. Here are some ideas:

• Follow a regular sleep schedule. Go to sleep and get up at the same time each day, even on weekends or when you are traveling.
• Avoid napping in the late afternoon or evening, if you can. Naps may keep you awake at night.
• Develop a bedtime routine. Take time to relax before bedtime each night. Some people read a book, listen to soothing music, or soak in a warm bath.
• Try not to watch television or use your computer, cell phone, or tablet in the bedroom. The light from these devices may make it difficult for you to fall asleep. And alarming or unsettling shows or movies, like horror movies, may keep you awake.
• Keep your bedroom at a comfortable temperature, not too hot or too cold, and as quiet as possible.
• Use low lighting in the evenings and as you prepare for bed.
• Exercise at regular times each day but not within 3 hours of your bedtime.
• Avoid eating large meals close to bedtime—they can keep you awake.
• Stay away from caffeine late in the day. Caffeine (found in coffee, tea, soda, and chocolate) can keep you awake.
• Remember—alcohol won’t help you sleep. Even small amounts make it harder to stay asleep.

Insomnia Is Common in Older Adults

Insomnia is the most common sleep problem in adults age 60 and older. People with this condition have trouble falling asleep and staying asleep. Insomnia can last for days, months, and even years. Having trouble sleeping can mean you:

• Take a long time to fall asleep
• Wake up many times in the night
• Wake up early and are unable to get back to sleep
• Wake up tired
• Feel very sleepy during the day

Often, being unable to sleep becomes a habit. Some people worry about not sleeping even before they get into bed. This may make it harder to fall asleep and stay asleep.

Some older adults who have trouble sleeping may use over-the-counter sleep aids. Others may use prescription medicines to help them sleep. These medicines may help when used for a short time. But remember, medicines aren’t a cure for insomnia.

Developing healthy habits at bedtime may help you get a good night’s sleep.

Sleep Apnea

People with sleep apnea have short pauses in breathing while they are asleep. These pauses may happen many times during the night. If not treated, sleep apnea can lead to other problems, such as high blood pressure, stroke, or memory loss.

You can have sleep apnea and not even know it. Feeling sleepy during the day and being told you are snoring loudly at night could be signs that you have sleep apnea.

If you think you have sleep apnea, see a doctor who can treat this sleep problem. You may need to learn to sleep in a position that keeps your airways open. Treatment using a continuous positive airway pressure (CPAP) device almost always helps people with sleep apnea. A dental device or surgery may also help.

Movement Disorders and Sleep

Restless legs syndrome, periodic limb movement disorder, and rapid eye movement sleep behavior disorder are common in older adults. These movement disorders can rob you of needed sleep.

People with restless legs syndrome, or RLS, feel like there is tingling, crawling, or pins and needles in one or both legs. This feeling is worse at night. See your doctor for more information about medicines to treat RLS.

Periodic limb movement disorder, or PLMD, causes people to jerk and kick their legs every 20 to 40 seconds during sleep. Medication, warm baths, exercise, and relaxation exercises can help.

Rapid eye movement, or REM, sleep behavior disorder is another condition that may make it harder to get a good night’s sleep. During normal REM sleep, your muscles cannot move, so your body stays still. But, if you have REM sleep behavior disorder, your muscles can move and your sleep is disrupted.

Alzheimer’s Disease and Sleep—A Special Problem

Alzheimer’s disease often changes a person’s sleeping habits. Some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night.

The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired for the challenges they face.

If you’re caring for someone with Alzheimer’s disease, take these steps to make him or her safer and help you sleep better at night:

• Make sure the floor is clear of objects.
• Lock up any medicines.
• Attach grab bars in the bathroom.
• Place a gate across the stairs.

Safe Sleep for Older Adults

Try to set up a safe and restful place to sleep. Make sure you have smoke alarms on each floor of your home. Before going to bed, lock all windows and doors that lead outside. Other ideas for a safe night’s sleep are:

• Keep a telephone with emergency phone numbers by your bed.
• Have a lamp within reach that is easy to turn on.
• Put a glass of water next to the bed in case you wake up thirsty.
• Don’t smoke, especially in bed.
• Remove area rugs so you won’t trip if you get out of bed during the night.

Tips to Help You Fall Asleep

You may have heard about some tricks to help you fall asleep. You don’t really have to count sheep—you could try counting slowly to 100. Some people find that playing mental games makes them sleepy. For example, tell yourself it is 5 minutes before you have to get up, and you’re just trying to get a little bit more sleep.

Some people find that relaxing their bodies puts them to sleep. One way to do this is to imagine your toes are completely relaxed, then your feet, and then your ankles are completely relaxed. Work your way up the rest of your body, section by section. You may drift off to sleep before getting to the top of your head.

Use your bedroom only for sleeping. After turning off the light, give yourself about 20 minutes to fall asleep. If you’re still awake and not drowsy, get out of bed. When you feel sleepy, go back to bed.

If you feel tired and unable to do your activities for more than 2 or 3 weeks, you may have a sleep problem. Talk with your doctor about changes you can make to get a better night’s sleep.

To learn more, please visit https://www.nia.nih.gov/health/sleep/good-nights-sleep#sleep-and-aging.