Communication in Dementia
Caring for a loved one who has Alzheimer’s disease (AD) is a challenge that unfortunately becomes more difficult as the condition progresses. People with early AD can still function independently, and communication is relatively easy. However, people with more advanced AD are less able to process what is said to them, and their responses become delayed. “They might have difficulty finding the right words and organizing them in a logical way, and people for whom English is a second language may revert to speaking in their native tongue,” says Mount Sinai social worker Sheila Barton, LCSW. “Eventually, they may speak less often and rely more on gestures.”
These changes make communication more difficult—but there are strategies that can help you and your loved one.
Early Dementia Early on, your loved one can still engage in conversation, but you may notice that he or she repeats things and forgets the names of familiar objects. “If you are talking about other family members or friends, or specific objects or places, it helps to refer to them by name instead of using pronouns like he, she, it, and there,” Barton advises. “If your loved one uses a word that is incorrect or out of place, try to encourage them to elaborate further so you are better able to understand what they meant.”
Moderate Dementia The middle stage of AD can last for many years, and over time, your loved one will have progressively greater difficulty communicating. You can help mitigate their issues by cutting back on distractions. “Background noise from a TV, radio, or traffic can distract a person with AD, making it even harder to converse with them,” Barton notes. “Talk in a quiet space, with minimal distractions.”
Two-way conversations may trail off because your loved one has lost his or her train of thought, but it is important to continue to engage them in conversation. Maintain eye contact, speak slowly and clearly, and take it one topic at a time. Give your loved one plenty of time to respond when you are talking, and don’t interrupt to correct them or try to prompt them unless they are struggling to find the right words. “Keep in mind that while people with AD have problems with short-term memory, their long-term memory is less impacted by AD,” Barton adds. “Talk about people and events from the past instead of more recent events. A photograph album can be a good way to stimulate conversation with your loved one at this stage, as you sit and look through it together.”
Questions are best framed as “yes or no” options—for example, instead of asking your loved one what he or she would like to drink, ask, “would you like some coffee?” and instead of asking, “how do you feel?” ask “do you feel tired?” Barton says another thing that can help is to think about how your loved one may be feeling at any given time. “It’s easier to communicate if he or she is happy and relaxed,” she explains. “If you know they are feeling frustrated about something, factor this into your approach, and be especially patient.”
Late Dementia Late-stage AD may last up to several years. It is likely that your loved one will have reached the point of relying on nonverbal communication, including facial expressions and sounds that aren’t proper words. “Encourage them to point at things they want if you’re unsure what they’re saying, and familiarize yourself with visual clues they may be sending you,” Barton says. “For example, a grimace may signal pain, while tugging at clothing may signal that they need to use the bathroom.”
Simple pictures can be a useful communication tool—you might want to buy plain postcards and draw happy faces, sad faces, angry faces; stick figures doing simple chores; a cup and plate; a bed. You also can find cue cards such as these online for downloading (see Useful Resources).
If you find it difficult to maintain conversation because you are distressed by the situation, remember that your physical presence can be very comforting to your loved one. It is important to provide reassurance and support at this stage, and it doesn’t have to be verbal. Touch is vital: take your loved one’s hand when you’re talking to him or her, or place a hand on his or her shoulder or leg. “However, you also should try to be sensitive to their reaction,” Barton cautions. “If he or she moves their hand away, see it as a sign they don’t want to be touched right now.”
Coming to Terms The gradual deterioration in communication between you and your loved one will likely be one of the most upsetting aspects of their disease, particularly because there will come a point when he or she will forget who you are. Barton experienced this with her mother, and found it incredibly painful. “She thought I was her sister, and I was lying about my age,” she recalls. “When I eventually could process this logically, it was evident that her loss of short-term memory meant that in her mind, Sheila was a baby. This didn’t fit with the fact the person in front of her was an adult. Finally, I asked her if she liked her ‘sister.’ She told me that her ‘sister’ was a ‘really nice person.’ That was enough for me.” Barton’s message in relating this personal story is that as AD progresses, you need to reframe your expectations and emotions to fit where your loved one is cognitively. In doing so, you may be able to better maintain a personal relationship that may be fundamental to your own wellbeing.
The post Communication in Dementia appeared first on University Health News.
Read Original Article: Communication in Dementia »
