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Tip of the Month – July 2016, supports for Dementia

Communication Supports for Individuals with Dementia

WHY use visual communication supports?

Individuals with dementia benefit from visual support systems in order to help them understand language and events around them, remember information and express themselves. Visual supports such as memory books have a huge wealth of evidence and research behind them.

WHAT are visual communication supports?

There are many different types of visual systems which may help.  It is important to remember that all learning is difficult for a person with dementia, so any type of visual system we put in place must be functional and useful and must be used every day. Photos of the visuals are listed and can be found on the TalkLink website or by emailing TalkLink with a request for a certain communication support.

  • Large print calendar or diary
  • Shopping lists (pictured beside) – could be hand written or printed pictures. You could laminate the visual shopping list and circle (with a white board marker) the items you need to get from the supermarket and then wipe the circle off when you place each item in the trolley to visually show that you have got that item.
  • Labels and signs – on doors or objects, e.g. place a label and photo on each door in a residential ward or labels on the linen cupboard shelves to sort towels, sheets, etc
  • Small objects as visual reminders
  • Cue cards
  • Timers – to visually show how much longer they have at an event or activity before they need to finish and do something else. There are apps for this or you could use a kitchen timer or egg timer.
  • White board – to write lists or write down instructions so that the person can refer back to them if they forget what they are doing half way through an activity
  • Daily Planner (pictured below) – see Tip of the Month on Visual Timetables .
  • Identification card – stored in pocket, wallet, tied to walker or walking stick or attached to lanyard
  • Menu boards – you could use Velcro or BlueTack to change the date and food options each day

shopping listdementia cardalzheimers cardactivities calandermenu


  • Memory book – sometimes called “This is your life book” or “All about me book”. See below section.
  • Memory wallet – like a memory book but a smaller version
  • Reminiscence (generic) photos and photo albums
  • Continuum lines – a scale to indicate how someone is feeling or the complexity of a task. You ask them a question and then they can point to a place on the line to show how they feel about that question. (pictured below)


  • Phone lists

picture phone

  • Talking Mats (pictured on the next page) – This is a commercially available resource that is a visual aid for decision making and sharing opinions during conversations. It is interactive and uses three sets of picture communication supports – 1) a topic (meal times, activities that are important to you, etc), 2) visual options (pictures or photos or hand drawn images of each of the options) and 3) a visual scale (yes, no, maybe/don’t know) – and a space on which to display them – this could be a white board or a carpet square or large piece of paper.  After you have finished talking about that topic you can take a photo of the board as a record of the conversation. The individual with dementia is shown each topic one by one and asked whether they ‘like’ that activity or ‘would like to do’ that activity, etc.  They place the visual under ‘yes’, ‘no’ or ‘maybe/not sure’. http://www.talkingmats.com/

 talking matstalking mats 2

  • Communication books. TalkLink can email resources.
  • Communication boards. TalkLink can email resources or they can be downloaded from the website.

cafefood choices

  • Pain board

pain boardpain board 2

  • Communication passport – The following links provide examples of communication passports: 1 page communication passport example, Communication passport template, ideas for making a communication passport and another simple communication passport template.
  • Visual scenes – This is a picture or photograph of a real situation on an iPad or other tablet device – it sets the context for communication. Each scene has hotspots that will ‘speak’ if you press them, e.g. a picture of the person’s kitchen will have hot spots – the fridge may say “I’m hungry”, the pantry may say “we need to go shopping for groceries”, the coffee maker may say “Let’s have a coffee”.  Scene Speak is a low cost app for iDevices.

visual sceneshot spots



  • A memory book is one of the most important visual communication supports to create. It is a connection to the present and a bridge to the past. This contains information about the individual’s life, history, hobbies, family, friends, holidays, etc.
  • It can be used to 1) refocus the individual during difficult symptoms, 2) to initiate conversations about their life and interests, 3) to enhance self-esteem, 4) as a security tool when they are in an unfamiliar place (such as the hospital).
  • Communication partners could ask the individual about 1) things they feel proud of in their life, 2) people who are important to them, 3) favourite memories, 4) hobbies, 5) places they have travelled, etc. If the individual does not respond to these questions, flip through the book and read the annotations and comment on items included in the book to initiate conversation.
  • A memory book can be created on paper using Microsoft Word or by handwriting next to photos in a scrapbook. It is best to keep the pages simple and uncluttered by having only the photos and some short and simple statements on each page.
  • Here are some templates – Personal Life History, Life History Book and All About Me
  • It could be created on the computer or an app. Book Creator and Pictello are useful apps for creating memory books, electronic ‘talking’ photo albums and for sharing personal information/stories/memories with others.

memory book


WHEN should I use visual communication supports?

It is important to use them throughout the day.  You may use a range of different supports (from the above list) during different times of the day.

Use them to 1) warn the individual of what is going to happen (visual time table or calendar or diary), 2) to reduce anxiety about what is going to happen (visual time table or calendar or diary), 3) to reduce anxiety about memory difficulties (memory book, communication passport, visual scenes, photo albums) and 4) to enjoy conversation (memory book, visual scenes, calendar).


WHERE should I keep the visual communication supports?

All of the visuals can be used at home, in residential care, at the shops and in other community locations. It is useful to stick the visual up where you would most commonly talk about that person/event/activity, e.g. have a visual timetable on the fridge (pictured beside), a shopping list on the pantry door, memory book and photo album on the coffee table or bedside table, identification card in their wallet or placed in their pocket each morning, pain board beside the bed or in the bathroom, photos of people by the telephone, etc. If it is available it will get used whereas if you have to walk to a different room to find the communication support, you probably won’t use it.

visual timetable


HOW should I use these?

  • Use them in natural everyday conversations to add to your verbal communication. You don’t stop talking when you use a visual communication support. The visual added to your verbal communication can increase the individuals understanding and memory recall.
  • Be consistent in using the communication supports each and every day.
  • Ensure that everyone communicating with the individual with dementia knows how to use the communication supports so that there is consistency.


TIPS for communicating with an individual with dementia

How you talk to people with dementia is just as important as the visual cues you use. You should train caregivers and communication partners to:

  • Ask simple questions
  • Give the person extra time to respond – count to 10 after you ask a question or make a comment before saying anything more
  • Speak in short, concrete sentences
  • Respond immediately to communication attempts
  • Maintain eye contact
  • Redirect the person from frustrating or embarrassing problems to things such as photo albums, memory books or other activities
  • Rephrase the conversation so far, to keep a topic focused when a person is confused
  • Try to have a shared visual referent to look at together
  • Avoid quizzing for the ‘right answer’
  • Encourage and validate the use of any communication techniques

From http://praacticalaac.org/praactical/fresh-look-at-aac-and-dementia/


VIDEOS to support training

University of Queensland have created some high quality videos for residential and home care support staff to learn about how to support communication:




Created by Jessamy Amm (TalkLink Speech Language Therapist) in consultation with Annabel Grant (Massey University Speech Language Therapist and Clinical Educator with Research interest in Communication disorders of Dementia).


Thanks to the following websites and organisations for resources and information:


Talking Mats

University of Queensland

Oxfordshire Total Communication

CALL Scotland

National Health System, England


Alzheimer’s Australia

Dementia Ability


To download this in a PDF version, July 2016 Tip of the Month – Dementia


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Paula Shennan

Paula Shennan

Speech Language Therapist at The Talklink Trust
I am a Speech and Language Therapist who joined the Talklink Auckland team in November 2011. I have an interest in the area of Assistive Technology and enabling and empowering individuals to communicate using various means.
Paula Shennan

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