Certain types of dementia (e.g., Alzheimer's, Lewy body, Parkinson's and frontotemporal dementia) may affect language ability. People who have these conditions may forget the names of people and things. They could use words that mean something entirely unrelated. Sometimes, they speak in "word salad," using a combination of words and sounds that seem to make no sense. Over time, many might stop speaking entirely.
How can you effectively communicate when someone has dementia and no longer speaks? Here are three suggestions to keep in mind when speech is no longer possible.
Keep talking to them! Many caregivers stop talking to a person with dementia who no longer speaks. However, this is not the best approach - always continue speaking. We should not assume a person with dementia who doesn't speak cannot understand what someone else is saying. Explain what you're doing, talk to them about things you know they enjoy, greet them, say goodbye and wish them well. Sometimes, people with dementia stop speaking because no one is speaking to them, so stimulate their brains with language.
Be aware that their eyes and face might not convey all they understand. People with dementia generally lose their ability to speak in the last stage of dementia (vascular dementia may be an exception). By then, they've also lost much muscle control, including those used to show facial expressions. They may have trouble shifting their gaze to a speaker's face. The lack of eye contact and facial responses does not mean they don't hear what you are saying.
Make sure your body language matches your speech. Communication goes far beyond understandable speech. Even when a person with dementia has lost the ability to speak and comprehend language, your body language, facial expressions and tone of voice still give them a clear window into your feelings. Show them the emotions you want them to feel because the emotions of people with dementia will often mirror their caregiver's body language.
Human beings have a deep need to communicate: to be known, understand and connect with others. This need does not decrease with dementia. In fact, the need becomes stronger because it is harder to meet. Maintaining communication, with or without words, will provide a better quality of life for you and the person with dementia.
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Deborah Bier, PhD, has a master's in counseling psychology and a doctorate in therapeutic counseling. In addition, Debbie has obtained the following credentials: