Those working in the field of dementia care know that they need to consult people with dementia about their views of services, but they often require help in finding starting points. Communication and consultation reports on a study exploring how staff can encourage people in their care to express their views and preferences. It describes how staff were supported in developing individualised approaches to consultation. Many of the service users who took part had significant communication difficulties, but despite these challenges, approaches which built on the person's strengths were explored. The work was tackled within the constraints of ordinary settings. Subjects explored include: descriptions of the process of developing ideas for approaches to service user consultation work; a novel approach to consent which has direct relevance to care practice as well as research; examples of various approaches to consultation tried by staff in the service settings; discussion of the range of factors which affect the scope and type of work undertaken. Communication and consultation should be read by policy makers, planners, managers and direct care staff. The report will also be of interest to student practitioners and researchers. It describes situations and difficulties which will be recognised by all, and demonstrates that meaningful consultation is possible despite the challenges.