Dementia and the Struggle to Communicate

It used to happen occasionally, but now almost all of my mom’s speech comes out garbled. If I walk up behind her when she’s zoning out, it sounds like she’s speaking an alien language. My standard reply is: “Yes, of course.”

Smoke on the Water

Foggy morning, Henning Pond

“Of course” is one of Mom’s favorite expressions. It’s a phrase she likes to hear from me. But most times I have no idea what I’m affirming when I say it. I try hard to understand her crazy words from context, but when she gets that distant look in her eye, I don’t know what part of her galaxy she’s discussing. My sister thinks our mom is remembering old conversations. She’s heard our mother mention the names of her siblings when she’s in these trances. That may be true at times, but more often I find myself  scanning the room, trying to discover what’s prompting her talk.

Mom’s language sounds like the babble of children who speak before they know words. They point at things, their eyes light up. Their sincerity animates every little thing they struggle to say. And my mom is a very tiny lady who can be cute as a three-year old when she starts telling you one of her stories.

She makes me remember when I was a little kid. I think I became a “writer” when she gave me my first crayons and some blank construction paper. The letters of the alphabet were still a mystery to me, but I had my own set of scribbles that I used to create “words.” My stories were mainly about Blackie, the puppy we had when I was still too young for school. She listened while I “read” her the symbols she couldn’t decipher, completely unaware that she was launching a career.

Mom’s stories today, however, are not about puppies and I’m afraid that I could misinterpret her. What if she’s trying to tell me about a problem or a pain? She’s still got dental issues that we don’t know how to treat — and her sluggish digestive tract is a chronic preoccupation. There might be other matters, too, that we haven’t noticed and she can’t explain to us.

The master reference book for caregivers, The 36-Hour Day, recommends that caregivers ask specific questions to try to narrow communications down to their simplest form. Authors Nancy Mace and Peter Rabins suggest pointing at body parts and asking, “Does this hurt?” or “Do you hurt?” instead of using a more general question. They also observe that people with dementia communicate better when they are relaxed. So it’s important to appear calm (even if you’re not) and make it easier for them to express important thoughts.

When in doubt, I use the hug method if I feel I haven’t gotten the true gist of her words. The slow, simple hug is 100% effective at settling her down. Once she is calm, I can tell more accurately if there is something weird provoking her. Hugs are basic human medicine that can be administered anytime, at no cost. They help many dementia patients relax enough to communicate. Imagine where we’d be if drugs ever achieve that kind of success rate.

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