Graceful Conversational Scripts: Keeping Your Social Flow When a Word Slips Away Due to Mild Cognitive Impairment

When this happens a lot, it can affect how much you want to be around other people, says Sarah Simon, a speech-language pathologist with SSM Health Therapy Services in Madison, Wisconsin. “Difficulty finding the right words can significantly impact the person’s ability to engage with others.”

But mild cognitive impairment doesn’t mean you have to give up meaningful conversation, says Fred Kobylarz, MD, MPH, a geriatric medicine physician at Robert Wood Johnson University Hospital and an associate professor at Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey.

“Communication is about connection, not perfect word choice,” says Dr. Kobylarz. “Staying socially engaged supports both emotional well-being and cognitive health.”

Planned Scripts to Maintain Poise

Our experts give these examples:

• “Give me a moment.”
• “It’s on the tip of my tongue.”
• “I know what I want to say, but I’m struggling to find the words.”
• “Give me a second, it’ll come to me.”
• “My brain hit the pause button.”
• “I’m sorry, my mind wandered off and I lost what I was about to say.”
• “I know the word, but I am just drawing a blank.”
• “My brain is taking a short break, please hold.”

Use whichever phrases feel the most authentic to you, says Kobylarz.

These comments tell your conversation partner that you need a moment to think, says Simon. “Having a quick phrase to use to ‘pause’ the conversation and allow yourself time can be helpful.”

Trying to remember a word fast can feel stressful, says Shannon Masella, a speech-language pathologist at Gaylord Specialty Healthcare in Wallingford, Connecticut. When you feel stressed or anxious, that actually makes it harder to remember a word because your brain is busy managing your emotional response, she says.

Masella suggests focusing instead on anxiety-reducing strategies. “Take a deep breath when stuck, and use one of the phrases that helps lower the pressure in that word retrieval breakdown moment,” she says.

Shifting to Visual Cues and Descriptions

• Draw what you’re trying to say.
• Use gestures or act it out.
• Point to the object.
• Use photos.

You can also describe the word instead of trying to say it directly, says Masella. “You might include where you find it, what it’s used for, what it looks like, and what it reminds you of,” she says.

Simon calls this the roundabout strategy. “For example, if you are struggling to find the word ‘toothbrush,’ you can act out using a toothbrush while describing [the term], ‘You use it to brush your teeth, with toothpaste,’” she says.

Choosing Active Listening Roles to Alleviate Pressure

You can incorporate your planned phrases into this idea to create a smooth transition. For example, you can say, “My brain hit the pause button. While it’s paused, tell me about your day.”

Listen to the conversation and move on rather than focus on finding the specific word you’re looking for, says Simon. “Typically, the harder we think about finding the word, the harder it gets!”

Educating Friends and Family on Supportive Prompts

Well-meaning family and friends can sometimes increase your word-finding anxiety. For better conversations, our experts suggest sharing these tips with loved ones:

• If I get stuck on a word, give me a moment of quiet.
• Don’t complete my sentences for me unless I ask.
• Ask just one question at a time.
• Acknowledge successful communication, not just mistakes.

If you get stuck on a word, Simon suggests loved ones can ask questions like:

• What does it look like?
• Where would you find it?
• How is it used?

“Reduce the pressure by giving them time, being supportive and encouraging them,” says Masella.

When to Talk to Your Doctor

• Forgetting to go to appointments or events
• Having trouble following the plot of a movie or show
• Difficulty navigating familiar places

Your provider may recommend speech therapy to help you communicate better with MCI. If you have sudden confusion, weakness, or vision changes, call 911 or go to your nearest emergency room, says Kobylarz.