People with dementia sometimes understand a written message but have difficulty understanding what you said or can read something correctly without understanding the meaning. You may have been surprised to find that they can sign their name long after they have lost the ability to write. Many people understand pictures and symbols, although the same symbol might not be as effective for different people. These different forms of communication all involve different skills and abilities, which may change over time and are different for different people. It is important to make the most of different forms of communication for as long as they are effective.