Jun 14, 2016

Aphasia in Memory Care Demystified

What is Aphasia in Dementia Care?


Rachael Wonderlin on Aphasia, Memory Care and Dementia Care
By Rachael Wonderlin
Alzheimer's Reading Room

"So to families and caregivers of people with dementia and aphasia, I say this: keep talking.


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Keep talking to them, keeping having a weird, one-sided conversation, and keep imagining that your loved one is responding.

Because, one day, they probably will respond."
“Oh, man,” I sighed, exasperated as I walked into Betty’s room. There Cara was, in another resident’s room, taking all of Betty’s tissues out of her bedside tissue box.

A couple interesting points here: one, Cara doesn’t speak much. She has aphasia, which means that she has trouble communicating verbally. Two, Cara walks around and in and out of other residents’ rooms constantly.

It was not a big deal, but I was tired. Seeing all of Betty’s tissues out of the box wore me out even more, because I knew she would need a brand new box, and that all of these tissues were now wasted.

“Hey, Cara,” I said. “Can we go out into the hallway and leave Betty’s room?” I began picking up the tissues that Cara had laid on Betty’s bed.

Cara—who speaks once in a blue moon—turned to me. “Don’t do that,” she said. “I’m making something.”


I was startled that she had spoken to me, and I realized something: Cara had laid the tissues out on Betty’s bed, each one next to another one, in a sort of quilt pattern. She was making something. It was not necessarily something useful, or something that I would have created with the intention and purpose that Cara was devoting to it, but there was a clear pattern here. Cara was creating some sort of art piece, and I was messing it up.


Two years ago I wrote my very first post for the Alzheimer’s Reading Room on the topic of aphasia - What is Aphasia in Dementia Care?  I want to expand on that topic a little bit more, based on what I’ve learned in the past two years about dementia care.

I was glad that I had, since the beginning of my work in dementia care, continued to talk to people with aphasia the way I talk to anyone. I speak, wait for a reply, and then respond to that reply. Of course, when someone has aphasia, they don’t reply. They just look at you, maybe give some indication that they know they’ve been spoken to—or maybe they don’t even seem to notice your attempt at conversation at all.

In any case, I realized early on that many people with aphasia and dementia do understand. Just because Cara did not always speak, did not mean that she didn’t know what was going on.

She was perhaps even more aware of her surroundings than some of my residents who did speak.

How to Get Answers To Your Questions About Alzheimer's and Dementia

So to families and caregivers of people with dementia and aphasia, I say this: keep talking. Keep talking to them, keeping having a weird, one-sided conversation, and keep imagining that your loved one is responding. Because, one day, they probably will respond—and you don’t want to be the one looking like a fool for underestimating their abilities.

Rachael Wonderlin also blogs and answers questions at Dementia By Day.

More on Memory Care and Dementia Care from Rachael Wonderlin

How to Understand the Difference Between Dementia and Alzheimer's Disease

The Effect of Emotional Super Glue in Alzheimer's Care

The Alzheimer's Reading Room contains more than 5,000 articles and has been published daily since July, 2009. You are reading original content the Alzheimer's Reading Room

"Aphasia" is a disorder characterized by a person's inability to communicate.

Aphasia is a communication disorder that results from damage to the parts of the brain that contain language (typically in the left half of the brain). Aphasia may causes difficulties in speaking, listening, reading, and writing, but does not affect intelligence.

In Alzheimer's dementia, the cognitive impairment extends beyond language and typically involves episodic (i.e., anterograde or day-to-day) memory. In primary progressive aphasia, gradual deterioration in language skills occurs in the context of relatively preserved nonverbal skills and activities of daily living.