RECAP: Relational Communication in Dementia Care

Communication in dementia care is often framed as a technical challenge – solved through interpreter access or translated materials. Yet for older adults from ethnically diverse communities, language barriers are deeply relational, affecting trust, autonomy, and emotional wellbeing. This presentation introduces a relational model of communication that reframes communication difficulties, language reversion and care navigation as identity-affirming processes requiring continuity, empathy, and cultural understanding.

Drawing on a qualitative systematic review of 51 international studies and early findings from a PhD study on older Polish Australians living with dementia, the presentation explores how evolving care needs intersect with ageing in place. It highlights the role of family and chosen support networks in bridging communication gaps and co-creating culturally safe care environments. The RECAP framework (Relationships, Empathy, and Cultural understanding through Access and Participation) is proposed as a practical model for embedding relational communication into dementia care.

The presentation will share lived experience insights, policy implications, and practice recommendations for workforce development, service design, and community engagement. It contributes to the broader conversation on personhood, dignity, and inclusion in dementia care – moving beyond compliance to connection.

This handout is an accompanying document for the International Dementia Conference 2026, please click the image below to access/download the handout:

Aim: Build a trusted relational base so communication doesn’t collapse under stress, progression, or language shifts.
In practice (what you can do):

• Prioritise continuity (known staff / trusted contact).
• Use a relational handover (what matters, what works, what escalates, what calms).
• Treat communication as a care intervention, not a task add-on.

Aim: Hear meaning, emotion and needs even when words reduce or change.
In practice:

• Slow down; validate; reflect meaning back.
• Flag: Actively attend to body language (gaze, posture, gesture, pacing, tension, withdrawal, agitation), especially when language is limited or interpreter-mediated.
• When distress escalates, assume a communication need before assuming “behaviour”.

Bridge sentence:

“Help me understand what feels hard right now.”

Aim: Understand identity continuity: migration story, values, family roles, stigma, norms of respect, and what “good care” means in that person’s world.
In practice:

• Ask about life story and what “matters most”.
• Recognise cultural norms shaping consent, privacy, who speaks, and how distress is shown.
• Use cultural understanding to adapt care, not label people.

Aim: Ensure language support is usable, timely and embedded—not merely “available”.
In practice:

• Record preferred language early, visibly, and re-check over time.
• Normalise interpreter engaged as a routine pathway (not a special request).
• Track uptake, note refusal, and repeat the offer later (needs/ preferences change).
• Brief and debrief with interpreters; avoid shifting interpreter labour onto families.

TIS National (Australia) – two useful links:

• Immigration/ Home Affairs TIS page:
  https://immi.homeaffairs.gov.au/settlement-services-subsite/Pages/tis-national.aspx
• Health.gov.au contact page for TIS National:
  https://www.health.gov.au/contacts/translating-and-interpreting-service-tis-national

Aim: Services can only address communication needs if the system makes them visible and legitimate.
In practice:

• Include the person with dementia in decisions in the way that works for them (supported decision-making).
• Build feedback loops and co-design with CALD communities (participation beyond tokenism).

Starter indicator set (adapt locally):

• Preferred language recorded and reviewed.
• Professional interpreter engaged: uptake tracked; refusal noted; repeat offer later.
• Continuity metric (trusted contact/ relational handover).
• Carer consent documented and revisited.
• Evidence of CALD participation/ co-design feedback loops.

Quick-start RECAP (2 minutes):

1. R: “Who do you trust most in your care team?”
2. E: “What feels hard today? What would help?” AND observe body language.
3. C: “What should I understand about what matters to you?”
4. A: Confirm preferred language AND interpreter engaged plan; repeat offers.
5. P: “Who do you want involved in decisions? And how?”

A pathway view makes in-language support predictable and resourced, rather than crisis-driven.

Diagnosis & assessment

• Preferred language check and interpreter engaged plan; dementia-aware briefing/ debriefing.

Post-diagnosis support and navigation

• In-language information; culturally safe explanation; link to community supports.

Care planning

• Include chosen supports; document consent and boundaries; revisit over time.

Coordination and ongoing care

• Continuity and relational handover; interpreter engaged when needed; repeat language preference checks.

Review and changes (including crisis)

• Repeat interpreter engagement offer (uptake/ refusal may change); capture feedback loops.

Evidence example (best practice): MINDSET

The MINDSET Study (NARI) describes co-design, trial and national implementation of dementia-specific interpreter training, including dementia knowledge and briefing/debriefing.
A peer-reviewed implementation paper reports national rollout of interpreter training for dementia assessments.

(Disclosure: Presenter references MINDSET as an external best-practice example, not as a project member.)

Rights-based aged care emphasises autonomy, person-centred communication and connection to significant persons. This requires explicit, ongoing consent and support planning with carers.

Use these prompts in care planning:

• “Do you consent to being involved in communication support? In what way?”
• “What boundaries should we protect (privacy, emotional load, time)?”
• “What would most help you in your caregiving role?”
• “What is your #1 priority right now?”
• “Would engaging a professional interpreter reduce pressure or risk?”

Preferences and capacity shift across dementia progression; repeat these questions in reviews, not only at intake.

• “What language do you feel safest in when tired, stressed or unwell?”
• “Who communicates best with you in that language?”

“Bridge People”: Recognise the real connectors (reference included)

“Bridge People” are trusted bilingual/ bicultural supporters who help older migrants navigate services; attributes include bilinguality, biculturality, multifunctionality and accessibility.
Reference: Liu X, Cook G, Cattan M. Support networks for Chinese older immigrants accessing English health and social care services: the concept of Bridge People. Health & Social Care in the Community. 2017;25(2):667–677. doi:10.1111/hsc.12357.

• Australian Government. National Dementia Action Plan 2024–2034.
• Australian Institute of Health and Welfare. NDAP indicators dashboard (what is being tracked).
• Aged Care Act 2024 (Cth) No. 104, 2024. Federal Register of Legislation. https://www.legislation.gov.au/C2024A00104/asmade/text
• Aged Care Quality and Safety Commission. Statement of Rights (includes person-centred communication and social connections).
• Australian Government. About the new rights-based Aged Care Act (overview).
• Department of Home Affairs. TIS National overview page (immi).
• Australian Government (Health). TIS National contact page.
• National Ageing Research Institute (NARI). MINDSET Study overview.
• NAATI. MINDSET project information (trial/training).
• Peer‑reviewed implementation: National implementation of interpreter training for dementia assessments.
• Liu X, Cook G, Cattan M. Bridge People paper.

Chudecka, A. (2026). RECAP: Relational communication in dementia care. Supporting identity, autonomy and inclusion for CALD older adults. Handout, International Dementia Conference (IDC), Sydney, Australia.