Serene Karplus, Nederland. Changes in communication are not always a sign of Alzheimer’s, as various physical ailments or medication reactions can also cause this. It can be an indicator, though, and the changes are unique to each person. In early stages, it may be as simple as repeated stories or difficulty finding a word, but many of us incur this without having anything seriously wrong.
As Alzheimer’s progresses, we might observe more often a tendency towards using familiar words repeatedly, easily losing a train of thought, reverting back to a native language, difficulty organizing words logically, and inventing new words to describe familiar objects. All of these challenges can cause a person to choose to speak less often.
Ongoing communication is important, no matter how difficult it may become or how confused the person with Alzheimer’s or dementia may appear. When communicating with a person with dementia at any stage, it is especially important to choose words carefully for simplicity and clarity and keep concepts on one topic at a time. “What did you do today? Did you see friends? Was it fun?” all in one breath is too much, too fast. The person may not recall what happened today, so we just set them up for embarrassment. A barrage of questions won’t help them or show that we care.
Here are a few friendly tips from the Alzheimer’s Association, which can be helpful at any stage:
Identify yourself. Approach the person from the front and say who you are. Keep good eye contact; if the person is seated or reclined, go down to that level.
Call the person by name. It helps orient the person and gets his or her attention.
Use short, simple words and sentences. Lengthy requests or stories can be overwhelming. Ask one question at a time.
Speak slowly and distinctively. Be aware of speed and clarity. Use a gentle and relaxed tone; a lower pitch is more calming.
Patiently wait for a response. The person may need extra time to process what you said.
Repeat information or questions as needed. If the person doesn’t respond, wait a moment. Then gently ask again.
Turn questions into answers. Provide the solution rather than the question. For example, say “The bathroom is right here,” instead of asking, “Do you need to use the bathroom?”
Avoid confusing and vague statements. The recipient may interpret your instructions literally.
Instead of saying, “Hop in!”, describe the action directly: “Please come here. Your shower is ready.”
Instead of using “it” or “that,” name the object or place. Rather than “Here it is” say, “Here is your hat.”
Give visual cues. To help demonstrate the task, point or touch the item you want the individual to use or begin the task for the person. Avoid quizzing. Reminiscing may be healthy, but avoid asking, “Do you remember when … ?”
Write things down. Try using written notes as reminders if the person is able to understand them.
Treat the person with dignity and respect. Avoid talking down to the person or talking as if he or she isn’t there.
Convey an easygoing manner. Be aware of your feelings and attitude; you may be communicating through your tone of voice. Use positive, friendly facial expressions and nonverbal communication.
People with Alzheimer’s and other dementias have more difficulty expressing thoughts and emotions; they also have more trouble understanding others. Here are some ways to help the person with Alzheimer’s communicate:
Be patient and supportive. Let the person know you are listening and trying to understand. Show the person that you care about what he or she is saying and be careful not to interrupt.
Offer comfort and reassurance. If he or she is having trouble communicating, let the person know that it’s okay. Encourage the person to continue to explain his or her thoughts.
Avoid criticizing or correcting. Don’t tell the person what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said if it helps to clarify the thought.
Avoid arguing. If the person says something you don’t agree with, let it be. Arguing usually only makes things worse, often heightening the level of agitation for the person with dementia.
Encourage unspoken communication. If you don’t understand what is being said, ask the person to point or gesture.
Limit distractions. Find a place that’s quiet. The surroundings should support the person’s ability to focus on his or her thoughts.
Focus on feelings, not facts. Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.
Family and caregivers of people living with dementia can become frustrated. Try to enter the slower speed and confusion of the person’s world and be patient with their challenges. To help us prepare for the changes the disease brings, the Alzheimer’s Association offers a weekly e-newsletter with coping and communication tips from other caregivers and their www.alzconnected.org site offers message boards and an online support community. For a variety of informative topics, visit www.alz.org or call the staffed 24/7 helpline with questions at 800-272-3900.
All adults are welcome at all Mountain MidLife and Nederland Area Seniors events, attended mostly by folks over age 50. Everyone is invited to all meals at the Nederland Community Center. Please call two days ahead for lunch reservations (a week ahead for dinners and breakfasts if possible) to 303-258-0799. Missed the deadline? Call anyway. Costs listed show first the over-age-60 requested anonymous contribution, then the under-age-60. Please note that all over age 60 are welcome regardless of ability to contribute financially.