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My Dad [in his 90's] had two regular caregivers that were a good match. Both women were raised on farms before moving to the big city, the same as my Dad.... and both had a great sense of humor and were able to laugh at Dad's puns. Dad was good at getting a conversation going as long as there was an interested party to listen, even if it was the 20th time they heard this story over the past year :)

I think what would be difficult is if the client was hard of hearing. My Mom had that issue, and even I has problems unless Mom heard one word about the subject, then she could talk about the subject.
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Try googling "conversation starters", there are a lot of great ideas!
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