Learning to communicate with a person with dementia is like having to interpret another language. With progressing symptoms and loss of words and speech, it is essential caregivers and families adapt to new ways of communicating and interacting with their loved ones. It is like studying a foreign language; it takes work, persistence, and practice.
How a person with dementia expresses themselves changes with the progression of
their condition, and it can seem very different from ours. It's incredibly challenging when these changes happen with someone close and how they usually communicated before becomes very different. They seem like a stranger who doesn’t speak a language you can understand.
Any language interpretation is never literal. The translator needs to capture the meaning of what's being said so that the language relates to cultural norms or the message the speaker is trying to convey. Anyone who has someone with dementia in their lives needs to become an interpreter.
I learned Spanish while living in Mexico in the 70s. Being immersed in a language I
didn't understand was challenging and frustrating most of the time until I began to pick up some of it. I learned words and would listen and try to recognize them in
conversations. Eventually, I recognized enough words that the ones I didn't know didn't deter me from understanding what was said. It was the message that was important. I believe this early training is one of the reasons I am very adept at interpreting what a person with dementia is trying to convey.
With dementia, they lose or substitute words, which often seems nonsensical. But if you listen closely, you will find the words they want to say among the ones that mistakenly pop out. When you relate what is happening around them to their message,
you will figure it out more quickly. It might have something to do with food or eating if it's at mealtime.
But how do you do this, especially if you have never had a second language and need
to become more familiar with how to learn it?
Begin by putting aside your usual expectations of the person. Understand those with
dementia are consistently struggling to express their needs, emotions, fears, or
thoughts. Memory loss creates difficulty remembering words, using the right ones, and
stringing them together correctly. Dementia progression commonly leads to incoherent speech or babbling. Frustration, anger, depression, or shutting down can happen when they aren';t understood. It becomes increasingly difficult for caregivers to care for someone when you don't know what they are trying to tell you.
But our communication functions with more than words. Non-verbal communication is
over 60% of how we understand each other. Our faces and eyes convey messages, as
well as the position of our bodies, gestures, and tone of voice. As a person with
dementia begins to lose words or understand yours, their innate ability to recognize
body language increases. However, the problem is that they lose cognitive reasoning
and need help understanding why you are sending the message, and commonly, the
meaning of your message gets misinterpreted.
When you learn to read the non-verbal cues of the "Dementia Language" your understanding of them increases.
Always talk to them face to face and constantly keep eye contact; eyes are the windows to the soul. Be overly expressive facially, and smile so that the other person will stay calm and focused if your message is not getting across.
Moderate your tone of voice. People with dementia have a more challenging time
hearing and understanding higher tones. Most become sensory sensitive to sounds;
background noises can cancel out your voice, or a high pitch can irritate them. Be
conscious of keeping your voice friendly and calm, especially if the person seems
confused or angry.
Sound sends out sound waves. When you place a speaker over a plate of salt, the salt
will move into specific patterns according to the tones played. Your voice also sends out waves, and like the salt, it physically affects the other person.
Keep your body relaxed and use hand gestures. Communication is enhanced when you
touch the other person while talking, connecting by getting "in touch" with them. How you touch someone is also communication. Always be gentle and non-invasive by just holding a hand or touching their arm. Stroking one's cheek or hair is a caring gesture reminiscent of mom. Hug them only if they permit you, or they are accustomed to it.
Never talk to them while standing over them when seated, or come up from behind and touch them even if you think they are aware you are there.
Those with dementia are losing the past, and the concept of the future is too abstract.
The world becomes relegated to what's happening now, which becomes important.
As dementia progresses, the person becomes more of an emotional being, and what
they feel right now directs their interactions with their environment and others. Emotions are contagious and emit energy. Try not to laugh when someone is laughing. How hard is it to stay calm when the other person is angry? In protests, when one person becomes violent, it infects the crowd, and the same holds for peacefulness in a group.
So, when you feel tired, frustrated, disgusted, or angry, this is communicated to the
person with dementia, as well as happiness, silliness, or contentment.
To finalize this lesson on learning the dementia language, remember that how you say
something or what you don't say conveys your message more effectively.
Communicating what makes them feel safe, happy, and cared for is relatively easy with
practice. After all, isn't this how we all want to feel with everyone?
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