Due to limited physical or cognitive abilities, the use of alternate forms of communication are often necessary for developing functioning dialogue between care workers and residents. How alternative communication is articulated to and in different types of care settings becomes the question. Through educational literature aimed at care staff as well as observations and interviews, the author of this paper explores the discourses and articulations among staff members in both a group home for adults with learning difficulties and a care home for elderly people. The author argues that different articulations and discourses guide the staff members’ room for manoeuvre and how the care workers view their responsibilities regarding alternative communication.