Why Bilingual Activities Matter for People with Dementia

When my father was diagnosed with dementia, our family felt the ground shift beneath us. The man who had told us stories of Cyprus in two languages, who switched effortlessly between English and Greek depending on who walked into the room, was beginning to lose his words. But something surprising happened as his condition progressed: while his English became fragmented, his Greek — the language of his childhood, his mother, his village — held on far longer than anyone expected.

This was not a coincidence. Research from the Alzheimer’s Society and other leading institutions confirms what many bilingual families observe: as dementia progresses, people often revert to their mother tongue. The language they learned first, spoke at home as a child, and associate with their deepest emotional memories becomes the one that endures.

So if a person’s native language is the last to fade, why are almost all dementia activities only available in English?

The Science: Why the Mother Tongue Persists

Researchers have found that the first language a person acquires is stored differently in the brain compared to languages learned later. The mother tongue is processed using implicit memory — the same deep, automatic system that lets us ride a bicycle or recognise a familiar smell. A second language, by contrast, tends to rely on explicit memory, which is more vulnerable to the damage caused by Alzheimer’s and other forms of dementia.

This means that for someone who grew up speaking Greek, Italian, or French at home and learned English at school or after moving to the UK, their native language sits in a more protected part of the brain. As dementia strips away newer memories and learned skills, the mother tongue often remains intact when English has become difficult or impossible.

Studies have found that bilingual dementia patients show asymmetrical language loss, with the first acquired language being preserved longer and used more frequently as the condition advances.

Care workers have reported remarkable transformations when they speak to patients in their native language. People who had become almost non-verbal in English suddenly engaged in conversation, smiled, and recalled memories when addressed in their mother tongue. The language itself becomes a key that unlocks a door everyone thought had closed.

The Problem with English-Only Activities

Walk into most care homes in the UK and you will find activity books, puzzles, and resources designed entirely in English. For someone who was born in England and spoke English their whole life, these work well. But for the thousands of people in the UK whose first language is Greek, Italian, Punjabi, Polish, or any other language, these resources miss the mark.

When you hand a Greek Cypriot grandfather an English-only coloring book with pictures of generic flowers and animals, you are asking him to engage with a language that may already be slipping away and images that carry no personal meaning. Compare that with a bilingual book showing an olive tree, a kafenio, and a game of backgammon — with prompts written in both English and Greek. The difference is not subtle. It is the difference between a blank stare and a smile of recognition.

Why Cultural Familiarity Matters Just as Much as Language

Language is only part of the picture. Research into reminiscence therapy — a widely used approach in dementia care that uses familiar objects, images, and prompts to stimulate memory — has consistently shown that culturally specific stimuli are far more effective than generic ones.

A person with dementia may not remember what they had for breakfast, but they may vividly recall the smell of their grandmother’s kitchen, the sound of church bells on a Sunday morning, or the taste of souvlaki at a village festival. These are not random memories. They are deeply encoded sensory experiences tied to culture, place, and identity.

This is why bilingual dementia activities need to go beyond simply translating words. The images, the scenes, and the prompts must also reflect the person’s cultural background. A book for an Italian grandmother should feature la cucina, il mercato, and Sunday lunch with the family — not a generic park scene with English captions translated into Italian.

What the Research Says About Coloring and Dementia

Coloring may seem simple, but its therapeutic value for people with dementia is well documented. Studies have found that regular coloring sessions can improve cognitive function, with one study reporting a 30 percent improvement in cognitive functioning among participants compared to a control group.

The benefits go beyond cognition. Research has shown that coloring helps reduce anxiety and agitation, two of the most challenging behavioural symptoms of dementia. It engages fine motor skills, encourages focus and concentration, and — perhaps most importantly — creates a calm, shared activity that caregivers and loved ones can do together.

When coloring is combined with culturally familiar images and bilingual text, the effect is amplified. The images trigger memories. The native language prompts spark conversation. And the simple act of coloring together provides a moment of connection that both the person with dementia and their caregiver can treasure.

What Families Can Do

If you are caring for someone with dementia whose first language is not English, there are practical steps you can take to incorporate bilingual and cultural activities into their daily life.

Use their native language. Even if your own grasp of the language is limited, simple greetings, familiar phrases, and songs in their mother tongue can make a real difference. Do not worry about getting it perfect — the sound of the language itself is what matters.

Choose culturally specific activities. Instead of generic puzzles and activities, look for resources that reflect their heritage. Photos from their home country, music they grew up with, and books featuring familiar scenes all help to stimulate memory and engagement.

Sit together and be present. You do not need specialist training to use a bilingual coloring book with your loved one. Sit beside them, read the prompts, and let the images guide the conversation. Follow their lead. If they want to talk about the olive tree on the page, listen. If they want to colour in silence, that is meaningful too.

Share with their care team. If your loved one is in a care home, let the staff know about their linguistic and cultural background. Provide them with appropriate resources and encourage the use of their native language in daily interactions.

A Personal Note

I created the I AM Memory Book Series because I saw what happened when my father — a proud Greek Cypriot man — was given something that spoke to who he truly was. Not a patient. Not a diagnosis. But a grandfather, a husband, a man who loved his village and his language and his family.

When he sat down with the first book, he smiled. He pointed at the olive tree and said something in Greek that made my mother cry. He remembered.

That is what bilingual activities can do. They do not cure dementia. Nothing does. But they can open a window — even if only for a moment — to the person who is still there, waiting to be reached in the language they have always known best.

Maria Darling-Jones is the creator of the I AM Memory Book Series, available on Amazon UK and Amazon US.