Should You Be Concerned When an Elderly Person Talks to Themselves?

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If you are a caregiver to an elderly loved one – a parent, in-law, or grandparent, perhaps- you might have heard them talking to themselves at some point. While it is normal to be alarmed at first, there are certain signs that will let you know if this situation is something you should be worried about.

It is a universal truth that certain diseases are more common in elderly patients. Neurodegenerative diseases such as dementia and Alzheimer’s disease are especially worrying for most people. So, it is perfectly understandable if you are concerned the first time you hear your loved one talking to themselves.

However, in many cases, an elderly person talking to themselves can be perfectly normal. Since every case is so different, the first thing you should do is keep an eye out for any changes in your loved one’s daily routine, mood, habits, and activities. As a starting point, this should give you enough information to realize when something has changed, so that you can discuss any new findings with your loved one’s doctor.

When Is It Normal?

Some people talk to themselves their entire life as a way of “thinking out loud”. If your loved one is one of these people, and they have been talking to themselves when alone for a long time, then there is likely nothing to worry about.

If your loved one is suffering from some degree of hearing impairment, they might be talking to themselves louder than usual because it’s more difficult for them to hear their own voice than it used to be.

senior man staring off into distance on a black backgroundMake sure to talk to your loved one and ask them if this is a habit they have always had. But, keep in mind that they might be a little bit embarrassed at first, since talking to oneself does carry some stigma and it is likely that they won’t want you to worry about them. Reassure them that you will not judge them or ask them to stop.

As long as this is an old habit, and your loved one isn’t displaying any other sign of cognitive impairment, such as forgetfulness, confusion, mood changes, or irritability, you shouldn’t worry too much about it.

However, whenever you are caring for a senior, you should always make sure to be aware of any cognitive changes your loved one develops, since they can develop degenerative conditions as time goes by.

When Should You Worry?

In some cases, an elderly talking to themselves can be a sign of an underlying illness. Neurodegenerative diseases are more common in senior patients, and their early symptoms can go unnoticed if you don’t keep an eye out for them.


Dementia isn’t one specific illness; instead, it’s a term used to categorize multiple illnesses which cause cognitive impairment. It is one of the leading causes of disability in seniors, and it has an enormous impact on the lives of patients and their caregivers.

Alzheimer’s disease is one of the most common causes of dementia, making up 50% to 70% of all cases. Alzheimer’s disease doesn’t have a cure, but certain treatments can increase patients’ quality of life and slow the progression of symptoms, which is why it’s so important to diagnose it in its early stages.

Other causes of dementia include vascular dementia, Parkinson’s disease, and frontotemporal dementia.

Red Flags to be Concerned About

An elderly talking to themselves can be a symptom of the cognitive impairment caused by dementia, and it should be considered a red flag if:

  • The person didn’t use to talk to themselves and instead, only started doing it recently.
  • They don’t realize that they are talking to themselves.
  • They talk to their own image or reflection without realizing who it is.
  • They talk to themselves whilst in the company of other people.
  • They believe they are having a conversation with someone else.
  • They act as if there is something or someone in the room with them, i.e. hallucinations.
  • There are other changes in their personality or behaviour, such as memory problems, irritability, aggression, confusion, sad or lethargic mood, etc.

Could Grief Be a Possibility?

elderly woman grieving by crying in her handsSometimes, an elderly individual might start talking to themselves as a way to cope with grief after a loss –for example, that of a partner-. In these cases, they aren’t really talking to themselves; instead, they are trying to maintain the habit of talking to the loved one they have lost.

If you notice your loved one does this after going through a loss, and there are no other changes to their behavior or personality, this could be the reason. If, in addition to talking to themselves, they become apathetic and lose interest in the things they usually enjoyed, consider a visit to the doctor to rule out depression, which is another common ailment in the elderly.

Final Thoughts

Ultimately, an elderly talking to themselves can have a myriad of causes, and you should always try to talk to your loved one to understand what they are going through. Know their personality, quirks, and habits so that you can recognize the early symptoms of any disease and make sure they receive the appropriate treatment and are comfortable in their surroundings.

Having a loving, understanding, and warm environment can make a world of difference when caring for a senior. Make sure your loved one feels cared for, understood, and autonomous; this will help you maintain a communicative and trusting relationship. This will be extremely helpful when you need to start a new treatment, therapy, or make changes to your environment or routine in order to uphold their quality of life and comfort.

How have you dealt with a senior loved one talking to themselves? Tell us about it in the comments below.

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