As Alzheimer’s disease develops, one of the first affected areas in the brain is the hippocampus, which is responsible for forming memories.
When memories are formed, they are linked to semantic understanding, allowing the individual to complete sentences and connect words to items. As the brain deteriorates with the disease, language processing and speech begin to deteriorate.
Your loved one may struggle to form simple sentences or understand conversations, and the use of incorrect words or phrases is very common. They may have difficulty naming objects and rely more on gestures. Slurring or stammering speech is evident, and repetitive speech becomes challenging and frustrating for the caregiver.
The caregiver should use gentle tones when communicating with his or her loved one and short, simple sentences and commands, such as “Sit in this chair” or “Use your walker.”
Unpleasant voices divert from the message, so caregivers should be mindful that their tone is not whiny, squeaky or piercing. Using a higher-pitched voice can alter the meaning of a sentence, turning it into a question, which can confuse and disorient the affected individual. The caregiver should try as much as possible to meet their loved one in his or her reality and go with the conversation at hand, even though it may not be coherent.
Oftentimes, caregivers play “verbal scrabble,” meaning they strive to finish the affected individual’s sentences or to fill in the blanks of what he or she is trying to say. This practice interrupts the individual’s thought process and subject transitions causing him or her to lose their train of thought. It is helpful sometimes for the caregiver just to be silent.
In “The Talk Book,” authors Gerald Goodman and Glenn Easterly write: “Let the silence be. Silence can open up tentative talkers, gives the other person permission to speak, and can bring reluctant conversationalists back for more.”
Additionally, as the caregiver waits, it helps the individual to organize his or her thoughts, and is a sign of support, an indication that the caregiver is being attentive and understanding.
The affected individual also responds better to rephrasing. Instead of constantly repeating the same instruction or comment over and over again, the caregiver should just rephrase what he or she is trying to say.
Additionally, succinct messages are more apt to be received. Try saying, “Bath time!” instead of “It’s time to take your bath. Let’s go to the bathroom.” The latter contains too many words and will leave the affected individual confused for a response or action.
Learning the language of dementia means using everything as a means to communicate. Anything that sparks dialogue — photos, artwork, newspapers — will help the affected individual stay connected to others and maintain a quality of life.