Often, the first notable symptoms of people with Alzheimer’s disease are difficulties with speech. In the beginning, they might be able to carry on everyday conversations but forget a word here and there. On other occasions, they might find it hard to resume a conversation if they are interrupted. These communication problems are relatively common to all of us. In people with Alzheimer’s, however, language issues gradually become more apparent. It becomes increasingly difficult for them to learn or remember new phrases, expressions, or slang. Additionally, they might start confusing the meaning of words. Also, it is hard for people with Alzheimer’s to hold several ideas in their heads at a time which results in them jumping from topic to topic without making a coherent sentence.
Moreover, persons with Alzheimer’s disease will struggle to make sense of what other people are saying. This is why communicating with someone with Alzheimer’s disease requires excellent listening skills, patience, and understanding. Learning how to better communicate with these persons will not only help the both of you to understand each other better, but also helps ease the frustration that tends to develop due to miscommunication.
The Alzheimer’s disease is typically divided into three stages although there is a seven-stage-model adopted by experts to follow the progression of the condition. The three-stage-model, however, is easier to comprehend and we shall use it to prescribe the different approaches to communication while dealing with an AD patient.
Stage One Alzheimer’s
Also known as Mild Alzheimer’s, it is characterized by minimal memory loss especially of events that just took place. The individual will more than likely still be able to go on their daily activities but might start forgetting familiar names and words while speaking. They will also experience an impairment of their judgment and attention span.
Tips for effective communication:
- Do not exclude the individual from conversations with others.
- Talk directly to them if you want to know how they are doing.
- Be patient and take the time to listen to their response.
- Do not finish off their sentences for them unless they request for your help in finding a word.
- Inquire what they are still comfortable doing or what they might need help with.
- Use your intuition to find out which mode of communication they are most comfortable with. The options may include face-to-face conversations, phone calls, or email.
- Be humorous.
- Be frank and honest about your feelings.
Stage Two Alzheimer’s
Also known as Moderate Alzheimer’s disease, the symptoms of this stage are for the better part an increased severity of the symptoms of the initial phase. Social and professional functioning deteriorates further due to the increased difficulties in memory, initiative, speech, and logic. It is during this stage that the individual starts to forget the names of their family and friends. In other instances, they might even fail to recognize persons that were once close to them. This stage is typically the longest and may last for many years.
Tips for effective communication:
- Allow them a lot of time to respond so that they may think about what they want to say.
- Remove all distractions and have them in a quiet space when you want to engage them in a one-on-one conversation.
- Be supportive and patient. Additionally, be continually reassuring as this will encourage them to explain their thoughts.
- Do not correct or criticize the individual. Rather listen intently to make sense of what they are saying.
- Do not argue with them. If you differ with something that they say, let it be.
- Speak clearly and slowly.
- Ask one question at a time.
- Use visual cues. When you want them to use an item, merely point or touch it.
- Avoid open-ended questions and stick with ‘yes’ or ‘no’ questions.
Stage Three Alzheimer’s
Also referred to as Severe Alzheimer’s disease, it is characterized by almost complete memory loss. An individual in this phase will require help in all the basic activities of daily living such as eating, basic hygiene, dressing, and toileting. The patient will be unable to walk unassisted and eventually will not even be able to sit up by themselves. Their ability to communicate will be lost entirely and eventually; their body forgets how to process standard biological functions required for sustaining life.
How to effectively communicate:
- Treat them with respect and dignity. Do not talk down to them as if they do not exist.
- Use sight, touch, taste, and smell as the primary source of communication.
- Just be there for them. They may no longer be able to recognize you, but your presence will be comforting to them.
Caring for someone with Alzheimer’s is undoubtedly challenging. However, it is important to note that their cognitive functions are impaired. This means that what makes sense to you doesn’t necessarily mean the same to them. Going out of your way and applying these tips will make the time spent with the patient less tasking and more enjoyable.
By Meredith Rogers @GeriatricNursing.org