Alzheimer's: A Glimpse into the Communication Challenges and Some Practical Ways to Connect

No amount of words can describe the feeling of living with someone who has Alzheimer’s disease. There is this realization that only one person is with the illness, but the whole family seemingly suffers with them.

A family who has a member with dementia will have to undergo many challenges, many adjustments, and a roller coaster of varying emotions. One of the most difficult parts of caring for a patient with Alzheimer's is communicating with them.

Here’s a glimpse of what conversing with a patient with Alzheimer's looks like:

They phone you many times a day asking you the same question every time. They don’t realize it was already the 22nd time to call.

They keep asking about relatives or friends who are already dead.

They are literally lost for words. They say, “The thing where I put my billfold and my phone in” instead of saying “My purse.”

They lose their train of thought. An Alzheimer’s patient will be in the middle of telling you a story, and then they suddenly stop because they have forgotten what they were telling you about, or have forgotten that they were talking to you.

Someone with Alzheimer’s may have difficulty organizing words in a logical manner. It may start as not knowing when to use the pronouns ‘he' or ‘she.'

They start cursing and shouting.

An Alzheimer’s patient may start speaking their native language. Your grandmother started speaking Spanish. She spoke Spanish as a child up until she was a teenager.

They make up new words and assign their own meaning to those words.

They cannot speak in full sentences, and they speak less often.

In the later stages, the patient would have lost their ability to understand language and then their ability to speak.

To communicate with your loved one who has dementia, your techniques should revolve around these three strategies: Respect, Simplify, Accommodate.

Respect

Do not argue with, criticize or correct the patient. Just listen and find their meaning.

Maintain eye-to-eye contact. This shows sincerity.

Speak to them at eye level. It helps the patient to not feel intimidated.

Do not touch an Alzheimer’s patient unnecessarily. Remember this especially if they don’t recognize you. You would not want a stranger to touch you either.

If they shout out of anger, let it pass. It’s never personal.

If an Alzheimer’s patient doesn't understand what you are saying, rephrase instead of repeat. If they did not understand you the first time, they probably wouldn't understand you the second time, unless you explain it in another way.

Do not talk about them within their hearing distance as if they are not there. Most importantly, do not talk negatively about them.

Mind your tone. As the saying goes, “It’s not what you say, it’s how you say it.” They may not understand what you are saying, but they would know if you are angry or irritated.

Be empathic. If you are frustrated, be patient and understand that they are probably experiencing frustration as well.

Give the patient time; time to comprehend you and time to respond. Do not interrupt them or finish a sentence for them, unless they ask you to.

Be patient. If they call you the 23rd time in a day, answer them briefly – each time. It is good to be thankful that they are still around to make that call.

Approach the patient where they can see you. Do not startle them.

Simplify

Speak slowly and clearly. The patient will respond better if they understand you.

Use short sentences and reduce complexity. Instead of saying, “What would you like to wear?” say “Would you like this blue shirt or this white blouse?” It should progress to just “blue shirt or white blouse?” and then to “Blue or white?” and then to “This or this?” (with you pointing at two choices) and then finally to “This blue shirt really looks good on you!” when the patient could not respond anymore.

Throw the pronouns away. They may have trouble understanding she, he, and it. Refer to the name of things or persons instead.

Remember to refer to other people by their first names.

Accommodate

If the patient insists on doing something, say ‘yes’ as long as they are kept safe. If they insist on sleeping on the floor, give them a mattress and some comfy pillows and blankets.

Be positive. Refrain from saying “Don’t do this.” Say, “Let’s do this instead.” (Don’t forget to appear excited).

Communicating with a loved one who has Alzheimer's can bring about frustrations and at times heartaches. But if you are able to connect with them in the right manner, your journey dealing with Alzheimer's disease as a family will be less bumpy and a lot more rewarding.