Cognition and communication changes can occur for many reasons, including a wide range of neurological conditions (for example, dementias, traumatic brain injury, stroke, Parkinson’s, aphasia, dysarthria, Tourette’s and brain tumours) and can also be part of typical ageing.
Neurological conditions can affect cognition (attention, memory, planning, processing speed) and communication (finding words, understanding, reading/writing, voice or social communication). These changes don’t reduce a person’s value or right to be included in discussions or decisions. A practical starting point is to assume competence, reduce communication load and use supports that help the person express their preferences.
Communication Tips to Try
- Set up for success: reduce noise, face the person, speak at a normal volume, allow extra time. Say: “Take your time, I’m not in a rush.”
- Use plain language and one idea at a time: avoid jargon and long explanations. Say: “Let’s talk about one thing first: your next appointment.”
- Check understanding with teach-back (without testing): ask them to explain in their own words. Say: “Just so I know I explained it clearly, can you tell me what the plan is when you get home?”
- Offer choices and support communication: yes/no questions, written key words, pictures, gestures, or a notes app. Say: “Is the main problem pain or dizziness?”
- Respond to emotion, not just facts: if the person is distressed or confused, acknowledge feelings and gently redirect. Say: “That sounds really worrying. Let’s work out the next step together.”
- Avoid common pitfalls: speaking over the person, correcting every mistake, rushing, or assuming non‑compliance is “behaviour.” Behaviour may signal unmet need (pain, fatigue, overstimulation, fear).
Plan supports early
Ask about communication needs at diagnosis and review over time.
Encourage a support person at key appointments, write down symptoms/questions and request written instructions. Consider early referral to speech pathology (communication strategies), occupational therapy (cognitive supports/routines) and check hearing/vision where relevant.
For older people, if you notice changes in memory, thinking, communication or daily functioning, consider an My Aged Care aged care assessment sooner rather than later. How aged care supports are accessed has changed, so early understanding and assessment can help timely matching of supports to needs and reduce delays if needs quickly escalate. Enquire via My Aged Care, with help from a carer, family member or health professional if needed.
Similarly, early planning for timely access to disability supports helps people understand NDIS pathways when changes relate to a permanent impairment or disability that substantially affects day-to-day functioning and is likely to require supports across a lifetime.
Connect early with community supports
Alongside clinical care, many people benefit from education, counselling, peer support and practical navigation. Depending on your situation, you may wish to connect to the many not-for-profit organisations supporting people across conditions such as dementia and head injury. These services can help with understanding symptoms, communicating with family and workplaces, planning ahead and finding local supports.
If you need help managing neurological symptoms or finding the right community organisation for you, contact our NeuroCare TeleNurse line for a confidential discussion in 1800 645 771.