Communicating with Alzheimer’s
It’s the same and it’s not
Never stop communicating. As Alzheimer’s disease progresses it slowly erodes one’s ability to communicate verbally. One of the classic symptoms of Alzheimer’s is the difficulty in ‘finding the right word’ during a conversation. Another common difficulty is structuring a logically sequenced sentence. These impairments are frustrating as you can imagine, and likely have seen. Communicating with Alzheimer’s is difficult, but don’t stop trying. Even more frustrating for the person with Alzheimer’s than the difficulty he is experiencing making his thoughts known to you is the thought that you have given up trying, or don’t want to communicate with him.
Communicating With Alzheimer’s is the Same and it’s Different
This might seem contradictory at best. Yes, there are some skills that will greatly improve how well you communicate with a person who has dementia, but every one of the suggestions below will increase the effectiveness of your communication regardless of to whom you are speaking. It’s just that we don’t always take the time or make the effort to be truly in a conversation.
Here is a short list of some common communication difficulties caused by dementia:
- Difficulty finding the right words
- Using familiar words repeatedly
- Describing familiar objects rather than calling them by name
- Easily losing a train of thought
- Difficulty organizing words logically
- Reverting to speaking a native language
- Speaking less often
- Relying on gestures more than speaking
There are many others, but these are some that you are most likely to see.
Suggestions for improving communication with Alzheimer’s
Be Sincere. As do children, people with Alzheimer’s disease have a way of knowing intuitively whether or not someone is being honest with them. They will often demand honesty from you, verbally or otherwise, and this is often interpreted by caregivers and family members as agitation. This honesty does not require that you always be completely truthful and factual. (Read more about the reality of someone who has Alzheimer’s disease.) This honesty is emotional sincerity, communicating in the moment.
Bernice was enjoying looking through her book of Fifties Sears Fashions, showing Holly the dresses she had ordered, and even the ones she had designed. (Bernice did work for Sears in the sixties giving sewing seminars to women all over the country.)
…the person with dementia is often beyond remembering how to connect with others and can only relate as she is, here and now. Bridging a connection is up to me, up to us.
~ Nancy Pearce Inside Alzheimer’s
This incident happened about the time that Bernice was entering the later stages of Alzheimer’s, and does not so much illustrate sincerity as it does judgment. Total honesty would require Holly to tell Bernice that her mother was dead. No matter how she said it, “Your mother died a long time ago, Bernice,” or “Your mother is dead, Bernice, you know that,” would have upset Bernice and caused her to repeat a mourning process that she suffered many years ago. Unnecessarily. And the whole process would be repeated the next time she asked about her mother.
Maintain Eye Contact. It is also important to make and maintain eye contact when talking with anyone who has Alzheimer’s disease. It shows that you are paying attention and makes it easier for him to understand what you are saying, or at least what you are meaning. The lack of this very intimate connection indicates to him that you are not truly interested in him as a person, not interested in what he is saying to you. Eye contact also assures him that you are being truthful.
Keep a Sense of Humor. Laughter may not always be the best medicine, as the adage suggests, but it is a very effective one, and the side effects are all good. A person often retains her sense of humor after dementia has robbed her of many memories and other cognitive abilities. The limbic system is responsible for emotional memories, and this part of the brain remains relatively functional when other cognitive abilities are impaired by Alzheimer’s. Be careful never to make a person with dementia the butt of a practical joke, and keep the level of humor appropriate to their stage. Political humor, for example, will not work well, but humorous mime likely will.
Use Touch to Reinforce Communication. Touch can be as simple as holding one’s hand or lightly touching the forehead with a comforting gesture. It might be a back-rub or involve lightly massaging the hands or feet. As yet there is not much clinical research about the effects of massage and touch on people with Alzheimer’s disease and other forms of dementia, but practitioners report many benefits.
Add scented oil or lotion to massage and get the additional benefit of aromatherapy.