Communication Versus Connection in  Late Stage Alzheimer’s Disease

Video Version Here

 

When you communicate with someone, anyone, typically you use words and body language to convey your meaning.

 

When you connect with someone, it can take different forms. Spoken or written language provides deep connection between friends and family members, as can smiles, hugs, pats, or more intimate gestures. You might connect with someone over a shared activity, such as playing a game together, without words. Members of an audience at a concert, theater, or exhibit are connected by the shared experience.

 

I’ve written quite a bit about how best to verbally communicate with a person living with dementia. While important, those blog posts assumed that the person living with dementia was in the early or middle stages. See these eight links for those posts.

https://www.reneeharmon.com/2020/06/17/speaking-alzheimers/

https://www.reneeharmon.com/2020/06/24/alzheimers-communication/

https://www.reneeharmon.com/2020/07/01/remember-to-speak-alzheimers/

https://www.reneeharmon.com/2020/07/08/keep-speaking-alzheimers/

https://www.reneeharmon.com/2020/07/15/speaking-their-language/

https://www.reneeharmon.com/2021/07/01/speaking-of-alzheimers/

https://www.reneeharmon.com/2021/07/07/conversations-with-dementia/

https://www.reneeharmon.com/2021/07/14/how-i-learned-to-speak-alzheimers-from-my-japanese-patients/

 

And remember, while language is severely limited in late stage Alzheimer’s disease, a person living with dementia can still communicate through their actions. Difficult behaviors are often the only way they can express frustration or anxiety. It is your job as a caregiver to try to decipher what is behind those actions. You also communicate your emotions—through your tone of voice and body language, and your loved one can understand that and often will reflect it back to you. If you are anxious, your loved one may become anxious.

 

Though communication can become increasingly problematic when living with Alzheimer’s disease or another dementia, connection can last well into the later stages of the disease.

 

Connecting encompasses so much more than conversation and language. You can connect with your loved one using the five senses. These will be shared connections, or ways to interact with your loved one in ways that show you care and are available.

 

Sound. Even if you cannot have a conversation with your loved one, you should still keep speaking, and using the approaches I have outlined before—address them at eye level, face-to-face, call them by their name, and introduce yourself by your name and your relationship to them. Because comprehension is so compromised at this stage in the disease, it’s less important to speak simply and slowly and with pauses.

 

Just the sound of your voice will be comforting, even if you prattle on. Try reading favorite passages of poetry, or from a well loved children’s book, or the Bible. Listen to recordings of birds or babies. Bring in tapes of persons speaking their native tongue if English is not their first language. Much has been written about the power of music in the late stages of dementia, so play recordings of favorite music from their youth.

 

Sight. Photo albums are a great way to connect. Even if your loved one no longer understands who the persons are in the photographs, just looking at smiling faces can be pleasant. Try bringing in children’s books with lots of large photos on topics that interested them in the past. Point out items in nature: trees, birds, flowers. Or watch nature videos together.

 

Touch. A gentle shoulder rub or holding hands can be comforting. You could try massaging lotion into your loved ones hands. Stroking an especially soft blanket is nice. Petting a cat or dog, either live or robotic, can be calming. Play-do might be fun.

 

Taste. Provide your loved one’s favorite foods. Maybe you can even lighten up on certain dietary restrictions at this point. Remember that choking can be an issue at this stage, so smooth, easy to swallow foods are best.

 

Smell. The sense of smell can be greatly diminished with age and with progression of the disease process, therefore, strong, but pleasant odors are best. Peel an orange and eat some slices together. Bring coffee, grass clippings, fragrant flowers, spices, or popcorn to smell together. Consider wearing your particular perfume or cologne every time you are together.

 

Connecting with your loved one who is living with Alzheimer’s disease can continue throughout their time with the disease. It will benefit them, of course, to have you close and doing activities with them, but it also will benefit you, as a reminder that you are still connected with your loved one.

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