As Alzheimer’s disease and other forms of dementia progress, symptoms may change and become more severe. In the early stages of the disease, a person with Alzheimer’s may still function independently, experiencing only minor difficulties with concentration or memory lapses. Over time, these issues worsen with increasing forgetfulness and confusion about people, places, dates and times. Another symptom that typically manifests over time is the patient’s increasing difficulty with communicating.
At first, the patient may find it difficult to come up with the right words to express a thought or have trouble understanding words that were once familiar. There may be frequent repetitions or stories being retold over and over. The patient might easily lose a train of thought or concentration, may put words together that don’t make sense, and eventually can become less and less verbal altogether.
This is all due to the effects of the disease on the patient’s brain. As the brain cells become ravaged by Alzheimer’s and die, concentration, memory and communication ability are all impaired. As communication ability deteriorates, it can be frustrating for the patient struggling to express a thought, and challenging for the caregiver who cannot connect with the patient through verbal exchange. Here are a few tips that can help when you need to communicate with someone with Alzheimer’s:
- Be patient and understanding. Try not to get frustrated or take it personally if someone with Alzheimer’s is having difficulty communicating with you. Remember that the disease is responsible for the difficulty, not the patient. Repeat information slowly, as needed, but do not create a sense of rushing anything.
- Focus on each other. Eliminate or minimize any distractions. External noises or stimulation can be disturbing and disorienting, causing agitation and discomfort. Make eye contact. Call the person by name and even hold their hands to signal your attentiveness.
- Keep things simple. Use short simple words and speak clearly and slowly. Break down any instructions into short steps. Ask questions that only require a “yes” or “no” response or offer a limit of only two or three response choices. Only ask one question at a time and patiently wait for a reply.
- Help find the right words. You can gently offer or suggest a way of stating something the patient is having difficulty expressing. But be careful not to be critical of the way something is being expressed and avoid the urge to correct words, complete sentences or fill in blanks too quickly. Listen, then gently demonstrate your understanding by repeating back to the person what they expressed in a way that is coherent.
- Try communicating without words. Part of effective listening is being able to pick up visual cues. The patient may employ gestures or facial expressions to convey a thought or feeling they are unable to express verbally. You could also try to incorporate some visual cues such as pointing, gesturing or demonstrating a behavior to help communicate.
- Always be respectful. Don’t talk down to the patient, treat them like a child, or talk about them as if they are not there. Don’t argue with the patient or express anger or resentment toward them. Always remember that the difficulties you are having with communication come from damage to the brain cells caused by Alzheimer’s, and not from the patient.
Caring for someone with Alzheimer’s can be full of challenges. Losing the ability to communicate with someone with Alzheimer’s can be particularly difficult and poignant. Being mindful of what to expect and how to cope can help caregivers meet the challenges with a sense of understanding and support.