Communicating with dementia or stroke impaired loved ones can be a challenge. We take the ability to communicate for granted using its many forms to relate our needs, understanding, and emotions. We don’t realize how essential it is to life until faced with the inability to speak, read, write, or comprehend. Just think about wishing someone “Happy New Year” for example. It slips right off the tongue. But think how difficult it would be if you had laryngitis and how frustrated you would be for just that short amount of time.

The inability to communicate, also known as aphasia, is an isolating experience that can result in severe depression. For caregivers the experience is no less frustrating and is an adventure in the practice of patience.

There are three kinds of aphasia: expressive, receptive, and global. What kind someone has is dependent upon where in the brain damage has occurred. In expressive aphasia speech is limited but the spoken word is understood, reading is usually intact but writing impaired. Receptive aphasic persons have difficulty understanding the spoken or written word but can speak. People with global aphasia are the most compromised. They are unable to speak or write nor can they understand the spoken or written word. Love ones with Alzheimer’s disease will traverse through each one as the disease progresses.

However, no matter what the cause of impairment it’s important to keep the lines of communication open. Loved ones must be encouraged to communicate and caregivers are encouraged to be patient.

The first thing to do is find out if your loved ones can hear. Hearing impairments are common with aging and can make persons appear cognitively impaired. If stroke is the cause they should be evaluated by a speech pathologist. An evaluation will determine the extent of impairment, best method for communicating, and a plan of action.

Use the “person centered” approach with the emphasis on the person with impairment, not on the person with impairment. In other words, see your loved ones for who they are and focus on their abilities, not on their disabilities. Always get their attention and communicate at eye level while maintaining eye contact. Speak slowly and calmly using short sentences and simple terms. Avoid talking down to them and don’t rush a response. Don’t shout! The inability to communicate doesn’t mean your loved ones can’t hear. Shouting also may be interpreted as yelling and can precipitate an angry or defensive response. Dementia affected persons are known to mimic body language, so pay attention to that, too.

The power of touch to communicate feelings can’t be denied. Touch is a form of communication that’s fundamental to life. Gently stroking, massaging or holding hands is comforting and anxiety reducing and may ultimately be the only form of communication your loved ones understand.

Don’t be afraid to use humor. When used appropriately it can lighten heavy moments and boost spirits. Laugh with, not at, your loved ones and learn to laugh at your own foibles.

Be patient, any type of communication impairment is frustrating for both of you. Sometimes it may be best to just step away and try again later.

Mary C. Fridley