This article explores the skills needed for effective communication with people who have dementia. It describes the factors that influence the communication process and the effect this may have on the nurse-patient therapeutic relationship. Cognitive impairment in people with dementia may limit their ability to communicate effectively. This may, in turn, affect the nurse’s ability to identify patients’ needs. Communication is central to providing good dementia care. The article examines some of the challenges nurses may face when caring for this patient group and suggests some strategies to overcome any barriers, enhance quality of care and improve patient outcomes.