Evaluation of staff training in psychosocial approaches to dementia typically reveals good knowledge at the end of the training but poor adoption and translation into practice after training ends. Here we describe our experiences piloting a training package designed to equip nursing home staff with the skills to communicate with residents with very advanced dementia who can no longer speak. We have previously described in this publication (PSIGE Newsletter 105, 2008) our first tentative attempt to use this approach to communication, which we call Adaptive Interaction, with a lady with very advanced dementia. Adaptive Interaction is based on Intensive Interaction, which uses the nonverbal fundamentals of communication as the basis for non-speech based interaction. We consider the challenges of enabling and supporting care home staff to adopt this approach and use it confidently and the lessons learnt for delivering similar psychosocial interventions in care settings.