When the Patient Is Truly at a Loss for Words
On average, we communicate about 15,000 words per day. A small percentage of that is considered meaningful by researchers. The human brain is remarkably capable of processing this onslaught of verbal missiles, as well as tone of voice and body language. However, the parts of the brain that process communication are progressively affected by Alzheimer’s and other forms of dementia, making even simple communication increasingly difficult.
As we age, we commonly begin to forget or substitute simple words and even names. Our train of thought can easily get derailed, or we get tangled up in multiple conversations or story lines. We can choose to laugh these off as signs of old age or become frustrated and withdraw. But when these symptoms become pronounced, they may signal the onset of a form of dementia.
Although your loved one with dementia may have lost their fluency, all is not lost as far as communicating. Following a few simple rules and keeping it simple will help keep the lines of communication open as much as possible. And remember, don’t take things personally. When the conversation or language comes across as offensive, it’s the disease talking, not the person’s heart.
Another general rule is to try to follow the person’s overall meaning and not focus on misspoken or forgotten words. If you understand what the person is saying in general, a little gentle coaching might help. “Did you mean it was Uncle Fred who took you fishing, not Grandpa?” If your loved one’s conversation is straying into the weeds, a calm verbal hand can draw him or her back in. “Mom, we were just talking about you and Dad taking drives in the country. What model car did you own? Where was your favorite ice cream stand?” Focus on staying focused.
Remember to stay calm at all times and don’t say or do anything to startle or agitate the person.
Approach him or her from the front and maintain eye contact. When words fail, gestures and a personal touch, if tolerated, can speak volumes. A kiss, a hand to hold, a stroke of the hair, a light massage, can be so comforting. A small act of kindness is always in order. A man in his 90s who was confined to a veterans home was so grateful that we would clean his electric razor and organize his wardrobe every time we visited. It doesn’t take much.
Gestures can reinforce verbal communication and make your meaning clearer. Point to the door when asking if he or she would like it closed. Nod your head “Yes” or “No.” Show the person the letter or magazine you’re reading. Take some clothes out of the closet so they can choose what to wear (if appropriate) when going out.
They say repetition is the key to learning. With a dementia patient, it can be the key to understanding. In a non-judgemental way, ask the person to repeat what they said, and be ready to slowly and gently repeat yourself as well. Patiently ask questions if you have to, over and over if you have to.
In all things, be supportive, even if you don’t agree with what the person is saying (or uses foul language, an unfortunate symptom of some disorders). Let your loved one know that you want to understand what they’re saying, that it’s important to you. It shows them you care and that they are important.
Try to keep distractions to a minimum. Turn off or silence radios, TVs, cell phones, and other sound sources when possible. Try to find a quiet room for talking.
Whether effective communication consists of a conversation peppered with a few gaps or gaffes, or long stretches of silent stares, there are benefits to making the effort to share feelings, thoughts, and experiences, including
- reducing anxiety and confusion in your loved one with dementia.
- strengthening the bond between you and your loved one.
- providing clues to discomfort, pain, dental, or vision problems.
- building trust.
- improving understanding and cooperation.
- making you a more confident, successful, and essential caregiver.
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