Oct 20, 2013

Five Alternative Ways to “Talk” With Someone Living with Dementia

For many caregivers, one of the most frustrating challenges they face occurs when they try to have a meaningful conversation with someone living with Dementia.

By Elaine C. Pereira
Alzheimer's Reading Room

Alzheimer’s is a serious neurological disease that essentially robs a person of their very identity!

Memories are distorted and skills compromised by this grim disease.

But perhaps the most frustrating challenge is trying to have a meaningful conversation with someone with Dementia.

Language, real reciprocal dialogue, is distinctly unique to humans!

When it is compromised by Alzheimer’s Disease, emotional connections with others can wither.

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Language requires very complex and intricate neurological skills. What is said has to be accurately processed by the brain and then a verbal response has to be conceptualized and executed to complete the reciprocal dialogue loop. This all occurs in milliseconds.

As the brain of an Alzheimer’s person deteriorates neurologically, language plummets as mumbling trumps intelligible words.

It is devastating for the family when their loved one can’t say “Hello,” can’t answer a question, can’t say their name or share their memories.

As bleak as this is, researchers theorize that even those with late stage Alzheimer’s are still
“in there.”

Before probing, prodding and praying for one more “Hi,” one more “Yes” to “Do you remember me?” or an accurate response to “What’s my name?” there are better, alternative methods for continuing “communication” other than words!

Connect Through Our Five Incredible Senses

Touch. The skin is our largest organ! By engaging contact through the skin we communicate powerful messages without ever saying a word.

Touching someone with a shoulder squeeze, cupping another’s hands, a hug, etc. instantly launches a cascade of wonderful endorphins, referred to as “internal morphine,” the phenomenal analgesic causing peptides in our brains.

Endorphins triggered by meaningful touch are becalming, communicate understanding, safety and love. Endorphins reduce stress, blood pressure and boost the immune system.

When verbal conversation is no longer viable, communicate your feelings through gentle touching hands along with words. The person with Dementia who can’t “talk” may still tell you “Hi, I love you” or “Thank you” with a return hand squeeze.

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

Taste. Technically known as Gustation, there are five separate and distinct tastes: sweet, sour, salty, bitter and umami, or savory. Taste and Smell, the next sense to be explored, are intricately linked and codependent. Sadly they are both seriously underrated as senses.

Taste is a powerful avenue of communication with someone struggling with the spoken word. Although personal interests vary considerably, most individuals with Alzheimer’s gravitate toward foods that taste sweet probably because tasting sweetness is the longest sustaining on our palate. My mother was no exception.

From my memoir, I Will Never Forget - A Daughter’s Story of Her Mother’s Arduous and Humorous Journey Through Dementia:
“Frankly, I couldn’t care less if she ate her way through every Snickers bar in Michigan, considering her age and condition…Her smile and obvious savoring of her clandestine treats was a treat to me amid so many less happy events. I savored it like she savored her coveted Snickers.”
I Will Never Forget

Smell/Aroma. Like its cousin Taste our Olfactory sense is underrated, but it serves as the silent back up to our sense of Taste. The flavor of the food is dependent on smelling it before and as we eat it. Everyone who has suffered from a stuffy head cold, obliterating the ability to smell, knows how bland food tastes as they grab another tissue instead of fork.

The enchanting fragrance of lilacs, the mouth-watering aroma of fresh baked bread and the yucky smell of baby poop all trigger memories from our past in powerful ways. We associate “smells” especially from our childhood experiences with past events that in turn can trigger responses in present time.

Whatever bouquets were relevant to someone else likely remain important avenues for continued connections, from fragrant flowers to potent vinegar!

Sound/Hearing. It is not uncommon to have difficulty sleeping in unfamiliar places, one of which is being disturbed by unusual sounds.

A creak, prolonged whirr or sudden buzz interrupts otherwise deep slumber.

Familiar sounds however can be comforting and remind us of the events from our past: a train whistle, wind chimes or the rhythmic bong of an old grandfather clock.

As previously stated, it isn’t “hearing” words per se that confound an individual with Dementia; it’s processing their subtle meaning and forming an appropriate response.

Music  in all of its beautiful variations has been shown to be a very effective modality with which to stimulate connections with an Alzheimer’s person.

Singing in particular utilizes different parts of the brain than conversational speech.

To facilitate the reacquisition of language skills damaged by her head injury, rehabilitation therapists are using singing with Gabrielle Giffords.

Vision. As traditional communication wanes in someone with Dementia, a plethora of visual connections remain bathed in familiar history. Photo albums with pictures of family and friends are especially meaningful images that can trigger comforting memories. Visual memory continues long after spoken language crumbles.

Seeing familiar objects from their past can spark engaging connections and possibly the most validating visual image of all,

the smile! 

As words failed her, I shared more pictures with my mom,

“She gently rubbed her slender fingers over the photos and smiled.”

Rummage through your attic and garage sales for anything that might be memorable to your loved one with Dementia: A rotatory phone. Adding machine. Recipe book. Baseball glove. Gardening tools.

Personal treasures like quilts, yarn or sewing kit. Schlep in anything that once may have had significant meaning to them and which may still unlock their visual communication abilities.

In summary, as meaningful conversation continues to fade, try communicating through the five senses.

Touch your loved one with Alzheimer’s in comforting ways. Bring in foods and fragrances that have meaning to them to stimulate their essence through Taste and Smell.

Play music and sing songs for them to Hear and bring in familiar objects especially photos for them to look at.

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Elaine C. Pereira is a retired school occupational therapist who worked with special needs children. She earned her bachelor’s degree in occupational therapy from Wayne State University and later completed her master’s degree. Pereira and her husband live in Michigan.

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