When someone is in the early stages of dementia, they are aware that they’re having trouble communicating. They know that they can’t find the words to use and they perceive others’ confusion. Their ability to talk remains strong, but their language is beginning to be affected.
It is important that we understand and know how to communicate with seniors experiencing dementia because they are still members of our society. If you are communicating with someone who is in the early stages of dementia, or someone who has mild Alzheimer’s, be sure you’re aware of these items:
Nouns are the first words to escape with dementia. Nouns are specific—people, places, things—and when you attempt to find a specific noun, it evaporates. Someone with dementia may have trouble naming specific items, even everyday items. Instead of naming exactly what or who they are talking about, they will talk around the item/person, describing it in detail until someone else can guess the correct word.
Verbs, adjectives, and adverbs remain strong, and the description can become quite vivid. The person with dementia is searching through their mental dictionary of words and cannot locate the exact word they are looking for, but they are in the right area—they’re in the right arena, the right section, the right row, but they’re not in the right seat.
The person with dementia is not playing guessing games with you! His/her vocabulary with descriptive words is so strong, you might assume that he/she must remember such basic nouns, but that is not the case. Understand that naming items, people, and places will be the most challenging words to locate.
Clichés and stereotypes become very useful to people with dementia. They can rely on a safe conversation that is predictable by using memorized responses. Social pleasantries are usually dependent on clichés, and continuing to use those clichés allows someone with dementia to maintain social appearances. When we say that someone “presents well socially” that often translates to “they use socially acceptable clichés in polite conversation”. As dementia progresses, people will increasingly rely on clichés when they’re in social settings.
3. Comprehension Challenges
Comprehension will become increasingly literal. It will be difficult for someone with dementia to understand sarcasm and other forms of humour. Analogies or metaphors are difficult to discern, and abstract expressions no longer make sense. In the middle of a conversation, you express “don’t throw the baby out with the bathwater.” Someone in the early stages of dementia may be confused and wondering how the conversation switched to bathing a baby. Abstract expressions begin to lose their meanings and are interpreted literally.
4. Redundancy Helpful
It is helpful to build redundancy into your conversation as a means of continually reaffirming the context of the conversation. Pronouns can be difficult to follow (he, she, they, etc.); naming the person about whom you are speaking ensures that the person with dementia can follow the conversation. It can be helpful to build other redundancies into the conversation as well.
A sentence such as: “Susan called last night, she’s coming to visit and bringing Evan,” could easily cause confusion for someone with dementia. Re-wording that concept into a series of simple sentences, with built-in redundancies makes the meaning much clearer: “Susan, your sister called last night. Susan is coming to visit. Susan is bringing Evan, her grandson, with her.”
As we practice these 4 points of awareness, we are including our seniors into meaningful discussions! Don’t forget that our seniors are active members of society.