I’m sure many of you remember the famous line from the movie “Cool Hand Luke,” “What we have here, is a failure to communicate.” I wonder how many times a day we are failing to communicate with our loved ones with dementia and how many times a day they fail to effectively communicate with us. 

Good communication is going to translate to good care. Unfortunately for people with dementia, there are a number of challenges, especially if they are having trouble finding words (expressive aphasia). The matter is only made worse when you learn that they may also suffer from receptive aphasia or the inability to understand what we’re saying.

It won’t matter how loudly or slowly we talk, it’s not going to help. Combine that with the fact that another characteristic of the disease is the dementia sufferer's inability to process well, and you can truly appreciate the challenge and also understand the importance of nonverbal communication.

I’m sure most of you have been out to a restaurant and within 30 seconds have been able to tell whether or not your server was having a good day. They’re not happy that you’re there, they don’t want to be there, and there are about a million other things they’d rather be doing than waiting on you.

Your loved ones will take their cues from you. They will read your body language, your facial expressions and interpret the tone of your voice. For that matter, your clothes can even send them a message. Putting on your parka? Then you must be leaving.  Do they feel safe when you’re gone?

Remember, our mission is to keep them in a “happy place,” so not only do we need to watch ourselves, but we must pay attention to them. Their face can tell a story. Do they look anxious? Make them feel less vulnerable. Do they look afraid or confused? Try and find the source and remove it. It could be a loud TV show, workmen in their environment making noise they can’t process, or a house full of laughing children.

Let’s be honest, if you suffer from Alzheimer’s dementia and you are not able to differentiate between the different noises in your environment, you’re going to have very long days. After all, most environments are not dementia-friendly. If mom or dad are now living with you in your home with your busy husband and school-age children, things can and do get hectic.

In all fairness, many with dementia have no problem dealing with a busy environment like a restaurant. One woman I work with takes her husband out of the dedicated memory care community where he lives and goes out with him almost every day for lunch at a different local restaurant. Truth be told, this is nothing more than “maintaining normal” for him as they did this regularly during their life together. As long as he continues to be comfortable doing this, then fine. The reality is that the day may come when it does get to be a little too much for him, and his wife will have to be ready to adapt. So before you take your loved one out, ask yourself how dementia-friendly the environment is going to be. That’s joining the journey.

As things advance, learn to use the effective techniques that will help keep your loved one feeling safe and secure. Put yourself at their eye level. Never come up to them from behind. If the person is comfortable with it, hold his or her hand with your hand on top when you talk to them. Don’t talk to them in lists, and tell, don’t ask. “Mom, it’s time for your bath.” “Dad, we’re going to go to eat now.” “Grandpa, we’re going to see your doctor to make sure you stay healthy and strong.” If you ask and they don’t understand what the answer is? The answer you’ll  get will usually be No!

Questions? Email me at repe@careforcaregivers.org. Join the Journey.

Robert E.P. Elmer III, of Stonington, is a senior care adviser and Alzheimer's care specialist. His website is www.careforcaregivers.org.


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