How to talk to people with Alzheimer's

Relationships and communication go hand-in-hand, so how can we have a close relationship with someone who has Alzheimer’s if they can’t communicate clearly with us? It can be like trying to talk to a foreigner in a language we don’t understand. 

To help to translate their language and navigate this uncharted terrain, here is a short information guide with some useful tips for your journey.

Meaningful communication

When my mother had end-stage Alzheimer’s she said, ‘You talk to me. Nobody else talks to me.’ Of course other people talked to her, but not in a way that was meaningful to her and let her know she was understood. 

How can we engage meaningfully when we don’t understand what is being said or done? The key is for us to be flexible and engage in their world and respond from that position, as we do with young children, rather than trying to impose our rational views on them. But this must always be done with care and integrity.

Non-verbal communication

In Alzheimer’s feelings are paramount and this means non-verbal communication is more important than words. What we are feeling is conveyed through our facial expressions, particularly our eyes, as well as our voice tones, touch and gestures. 

It might surprise you to learn that people with Alzheimer’s are extremely aware of these non-verbal signs. As brain cells die and cognitive functions decline, the part of the brain that enables empathy becomes more active. 

But it doesn’t end there. Having sensed our feelings, people unconsciously mimic us and reflect these feelings back to us. Knowing this has huge implications because what we are feeling will affect them and determine the mood of the relationship.

Touch is something from which people with Alzheimer’s can benefit greatly, whether it’s simply holding a hand lovingly or giving a full foot or hand massage. Touch promotes oxytocin, a hormone that acts as a neurotransmitter that brings about feelings of wellbeing and relaxation. Always ask permission before doing any kind of massage, then monitor the person’s responses and respect their wishes.

Verbal communication

Verbal communication is notoriously difficult with people who have Alzheimer’s. Often they say things that make no sense to us, leaving us not knowing how to reply, let alone reply meaningfully.

Due to loss of vocabulary people frequently can’t find the word they want to use. When this happens they substitute a word that has the same or a similar meaning but in a different context, leaving us none the wiser. Talking about when residents went to their rooms my mother said, ‘It’s elastic.’ The word she was probably looking for was ‘flexible’. So thinking about the associations of words will provide clues as to the intended meaning. 

Due to changes in the brain, people with Alzheimer’s often express themselves using metaphorical language. My mother said, ‘Margaret left with something in her ear last night.’ When I asked her what it was, she said, ‘The things I told her.’ 

So rather than dismissing what is said as incomprehensible, search for the meaning, talk about it and, if appropriate, gently ask questions. This will enable communication between you to continue

We have probably all experienced someone with Alzheimer’s being very direct. This is because the filters in brain that moderate thoughts for speech, no longer work. We would not be very popular if we said publically what we were thinking, but this is precisely what people with Alzheimer’s do. We need to understand this and accept we may be hearing the truth, at least from their perspective.

Still thinking

Despite damage to the brain and the severe impairment of speech, it seems that people with Alzheimer’s may still be capable of thinking normally. ‘I know my thoughts are clear, I’m confused when I can’t remember,’ my mother said. If we keep this possibility in mind, and continue to talk and ponder over questions, we can sometimes stimulate the person’s brain and help them to give a voice to their thoughts.

And last but not least, the most important thing we can do is let our hearts open and our eyes smile.

Maggie La Tourelle is a psychotherapist and writer, with ten years’ experience helping to care for both her parents at the end of their lives. She is the author of The Gift of Alzheimer’s – New Insights into the Potential of Alzheimer’s and its Care. www.thegiftofalzheimers.com