Communication Issues

 

According to the National Alzheimer's Association,

"Alzheimer’s disease and related dementias can gradually diminish a person’s ability to communicate. Not only do people with dementia have more difficulty expressing thoughts and emotions, they also have more trouble understanding others. The ability to exchange our ideas, wishes and feelings is a basic need."

They also indicate that changes in the ability to communicate are unique to each person. A caregiver may recognize differences in the person with dementia such as:

  • Difficulty finding the right words
  • Using familiar words repeatedly
  • Inventing new words to describe familiar things
  • Easily losing train of thought
  • Difficulty organizing words logically
  • Reverting to speaking in a native language
  • Using curse words
  • Speaking less often
  • More often relying on gestures instead of speaking

Just as this is frustrating for the person with Alzheimer's, it is also frustrating for caregivers. Over time, strategies for successfully communication under these circumstances have been identified. Knowing methods that work, such as distraction, make interactions much less stressful for both parties. Below are links to information on these strategies. And, if these don't quite work in your situation, take what does and adjust it until it meets your needs. Use these as creative beginnings. Also, if you can, when you find new strategies that work, share them with others through online chat rooms and bulletin boards. Remember how you felt when you were learning new communication techniques. Help others. It feels good.

 

The Duke Family Support Program offers a Tool Kit for Alzheimer's and Dementia Caregivers which supplies advice, tips, and strategies for communicating with a family member with Alzheimer's.

Talking With People With Memory Disorders

Strategies:

  • Speak slowly, simply, and concisely, always being mindful of the tone of your voice. Use concrete, familiar words. Do not use baby talk.
  • Give one direction or ask one question at a time. “Are you finished?” or “Here is the toilet.”
  • Don’t offer too many choices that may make it hard for the person to make a decision. Say: “Mary, would you like to wear the red dress or the green dress?”
  • Don’t avoid talking with the person who is having difficulty. Supply him with the right word or names and other information if you think you know what he is trying to say.
  • Avoid instructions the person may take literally such as “run down the hall,” or “hop into bed.” Use direct statements to initiate action or an activity, i.e. “It is time for supper. Let’s go to the dining room.”
  • Don’t assume the person did not hear you if there is no response. It may take a while to process what you said and then form an answer.
  • Watch for signs of restlessness and withdrawal indicating the person does not wish to communicate. Respect her wishes and try later.

Non-Verbal Communication: When Words Fail

When language becomes more difficult for the person with memory loss, you can help him or her with simple techniques that offer reassurance and encouragement. A smile, eye contact, and attentive listening help support and prompt the individual’s efforts to communicate.

  • Begin by eliminating distractions such as noise from a radio or TV that make it harder for the person to concentrate on what you are saying.
  • Let the person see you on his level. If he is sitting, sit facing him. Use touch to get the person’s attention. Holding hands or gently touching the individual’s arm or shoulder may elicit trust and cooperation. However, be sensitive and respectful of the person who doesn’t like to be touched.
  • Learn to “read” the individual’s behavior. The person with Alzheimer’s disease may have a flat mood. He may show little expression or emotion. He may also misinterpret situations or the intent of others. Extreme or quick gestures may be seen as threatening. Move slowly and calmly.

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From the Perspective of a Person With Alzheimer's

How To Have A Good Conversation

Talking to an individual with memory loss represents a special challenge. He may have trouble organizing words into thoughts or lose his train of thought in the middle of a sentence; he may substitute or make up words that are incorrect; he may repeat favorite words or tactless curses; and he may misunderstand what you are trying to tell him. Yet, the person with memory loss can and wants to be involved in communicating with those around him. He asks that you be mindful of his difficulty and to remember things from his perspective.

Always treat the person with dignity and respect. He is an adult with adult feelings, still capable of embarrassment, humiliation, and of discerning when others are being condescending, impatient, or not interested in what he or she has to say. He is often aware of his difficulty in communicating.

Patience becomes a virtue—patience to listen and the willingness to repeat your answers to his questions. Remember, it is the disease and not the person creating this new and difficult challenge.

  • “Don’t lose patience if I ask something more than once. It is simply my way of letting you know that I don’t remember what you said the first time.”
  • “Have a sense of humor. It will help me lighten up about things I may have trouble with.”
  • “I am not less of a person because I have Alzheimer’s. Don’t feel sorry for me.”
  • “I am what I am and that’s all that I am. I think of myself as normal.”
  • “Please don’t ignore me as though I don’t exist. I am a human being. I am not invisible.”
  • “I think I have to feel like I’m useful.”
  • “Let me do what I can. Give me a try.”
  • “Consideration! Be considerate of me and of my feelings. I still have feelings.”
  • “Just because I have Alzheimer’s does not mean that I should not have a voice in what affects me. Don’t shut me out of decisions that I can still help to make.”
  • “I still enjoy hearing what goes on in the family. Don’t be afraid to report to me all the happy details. I can also sense when something’s wrong and feel worse when you hide things from me. Don’t be afraid if I cry or become upset. It is better than not knowing.”
Woman

 

 

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