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What I Really Meant to Say - Communication and the Stages of Alzheimer's

Verbal Communication

Dementia shreds a person’s verbal communication skills. As the disease progresses, your loved one may be unable to locate the words wanted, or may not be able to process the words you’re using — potentially leaving both of you confused and frustrated. One of the most difficult challenges while living with dementia lies in accepting and adapting to your loved one’s new communication pattern.

Typically, communication issues can be identified based on the severity of dementia. In the early stage, expect your loved one to be unable to find the right words to name things or complete thoughts, to scramble the sequence of events when telling a story, or to forget things that were just said. In the moderate stage, your loved one may be confused if you talk fast or use slang, need more time to respond to others or to join a conversation, or repeat questions or stories. In the late stage, your loved one will most likely only speak one to six words each day, use words that make no sense, or to repeat what’s just been said, rather than responding.



In order to cope, and to communicate with your loved one as positively and effectively as possible, consider the following techniques.

Get at eye level. Be sure to make eye contact with your loved one when speaking to them.

 

Speak slowly and clearly, and avoid using slang.

 

Allow your loved one time to respond, and repeat yourself as necessary. It may take a while for your loved one to process the information you’ve given them, and then formulate a response.

 

Keep instructions and responses simple. Avoid long explanations and complicated responses, and keep information to the point — offering one thought or instruction at a time.

 

Use empathy and supportive statements. This will show your loved one that you understand, and that s/he can count on you.

 

Use hand gestures to show by example what you want your loved one to do. Mirroring will help your words have meaning to your loved one more quickly.

 

Keep your body language and facial expression relaxed and friendly. As your loved one loses his/her ability to understand words, s/he will begin to watch your facial expressions and body language in order to understand.

 

Avoid negative statements. Words like “no, don’t, can’t, shouldn’t” make adults feel foolish and angry. Try to use positive words to convey your message instead. A negative response would be, “No Mom. You cannot go out now. It’s dark and you don’t work anymore.” A positive response would be, “Hey Mom, it’s a bit early. Will you help me finish the dishes? We can go for a ride later.”

 

Avoid the desire to correct faulty memories. If your loved one tells stories where the facts are incorrect or they call you by the wrong name, do not correct them. Pointing out over and over that they are wrong, or that their memory is flawed will not help them. The brain damage they are experiencing is non-curable. They cannot learn from their errors or correct them, so never argue or attempt to reason.

 

The use of validation rather than reality orientation may be needed. Your loved one’s reality is as real to them as yours is to you. It is best to use empathy and supportive statements, and distract them onto another topic. Go along with them when you’re able to, and use humor as appropriate.




 

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