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I've been doing some hospice volunteering recently. One of my patients is a sweet lady in her eighties with dementia and other ailments. She will respond to my efforts at conversation with word salad, rarely speaking in complete sentences or making any sense. She will smile and laugh at my jokes so it seems there may be some level of comprehension, but I'm wondering how much is getting through and if the correct phrase or response is in her brain and she has just lost the ability to find the right words in response. I'd like to find some way to communicate with her but she may be too impaired. I don't know. Any thoughts out there?

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I wonder if those with dementia would understand basic sign language, not the official sign language, but simple jesters that might be universal.

With modern science you'd think doctors could trace how one is thinking depending on what stage they are in.

Windyridge, how nice that you do volunteer work, it's a good feeling helping out :)
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Thanks for the comment flyer. Now that you mention it, I have noticed when I'm with this lady, I find myself pantomiming to get my point across and it seems that she understands. For example was telling her about building my garage and I made hammering and painting motions. She seemed to understand this, but her responces was jibberish. I'm just dying to know what's going on in there.
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When I took the AAA/Alzheimers' course on caregiving, we were shown a movie reflecting different stages of dementia. Patients were asked by a caregiver/medical person to prepare sandwiches. At the higher levels of cognition, the women instinctively knew to remove the twist-em from the bread, remove the lunchmeat and cheeses from their respective wrappers, and use a knife to add mayonnaise and/or mustard.

Those in the more advanced stages not only had difficulty remembering what the instruction was, but had difficulty determining how to get the meat and bread out from their wrappers, etc. Using a knife to apply the condiments was also problematic.

Some of us were close to tears at that point. It was a sobering and frightening insight into how dementia can rob people of their cognitive abilities.

I think your patient probably doesn't understand what you're saying but is a very gracious and happy person who is responding in the only way she can. It may be that just the sound of your voice and your presence are stimulative for her, even if she's unable to cognitively communicate.

And kudos to you for your volunteer work; that must be very challenging but rewarding.
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WR, I was typing as you posted so I didn't see your response to FF's post.

If you want to see "what going on in there", I think the closest thing are the videos or demonstrations of brain synapses and neurological disconnection. This is a pretty good, basic and understandable place to start:

https://www.alz.org/braintour/synapses_neurotransmitters.asp.

If you've ever done any electrical work, think of a system of wires in which some of the wires break, severing the connection to other wires. Imagine that many of the wires have broken, and the electrical signals can't be transmitted.

That's a good example of the videos I've seen on the synaptic interruption that occurs in the brain.
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Garden, it just so happens that I'm a retired electrician. Your comment makes perfect sense. Thanks.
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When I talk to my LO with dementia - I have gotten to the point that I rarely try to figure out what he is saying, word salad and poor pronunciation make it almost impossible - I was asking him to repeat himself 3 and 4 times before I got it and most of the time really did not make sense, so it was frustrating for both of us. So I just babble away - as he seems to like it, may tell him a story from the news or remind him of times past -- seems to help if I end my story with "you know what I mean" and nodding. You may never know how much she comprehends but don't stop the communication, the fact she laughs and tries to communicate back with you shows you are making some kind of connection with her. Whenever I require an answer from my LO, I put the question to him in a way that he only has to answer yes or no and that seems to help.
I admire your volunteer work and being so caring.
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It sounds like she may have aphasia. Here is the URL to go to a thorough explanation of what it is. One can have it from a stroke or even Alzheimer's. it's a good explanation so check it out. webmd/brain/aphasia-causes-symptoms-types-treatments.
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Thank you to Louise and Lorreta. Very helpful info. I will check out aphasia and I like the idea of chatting to make a connection. I had kinda fallen into that with this sweet lady the other day. She may not understand but the attention and chatter seem to engage her. Btw, what is LO?
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Windyridge, LO - loved one
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My mother has Parkinsons, Dementia, and a lot of other health issues. My husband and I care for her. She has aphasia and it is very difficult to communicate with her sometimes. Because I know my mother so well I'm able to get the information out of her but sometimes I'm not. I find that if I sit down with her and look right at her we can figure out together what it is she wants to say. It's not always successful but I feel like if I at least give her my full attention she feels less helpless. If we aren't successful I tell her we'll take a break and come back to it later. That might not always happen but I hope it gives her some sense of comfort that I took the time to try and figure out what she is trying to say.

I wish you much success in your work. It's very commendable of you. I'm also sure that this women is grateful for your time even if she can't convey that to you.
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