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Dementia and Communication: Speech vs. Language

 

What is the greatest challenge for a family caregiver of someone with dementia? Likely, the number one challenge is communication.

 

Why is communication so difficult? 

 

The person with dementia is still able to speak—in some cases, the person with dementia may talk incessantly.  His or her ability to speak is not affected.  Uttering sounds, pronouncing words, even using complex vocabulary is still quite possible, and yet, communication is an enormous challenge.

 

When someone has dementia, speech is not hampered, but language is affected.  What is the difference between speech and language?  Speech is the physical ability to produce meaningful sounds.  It is the complex interaction of muscles and nerve endings all interacting together to produce sound.

 

 

Language is not about the sounds being produced; language is the meaning behind the words.  In any language, there is a set of rules about how to use words: grammar dictates that words must agree with each other, syntax ensures meaningful placement of words into sentences, semantics is a mental dictionary of words that have meaning to us. 

 

When someone has dementia, their language can be affected. Their dictionary of words may become scrambled and finding the right word is impossible.  When the correct word cannot be found, people with dementia often substitute the next available word…but because the dictionary is so scrambled, the next available word may not be related at all to the word for which they are searching.  Interpreting the conversation can become difficult!

 

 

Language and the words associated with it are not the only element of communication that is affected for people with dementia.  Communication relies on extensive non-verbal cues as well, such as posture, body language, facial expression, etc.  Understanding and interpreting all of these signals can be difficult for someone with dementia, and their ability will fluctuate over time.

 

The person with dementia or Alzheimer’s is communicating in the only way that he/she is able to, at that moment.  Throughout the various stages of dementia, there are different strategies that can improve communication between family caregivers and those with dementia.

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