Imagine how isolating, problematic and exasperating it must feel to be incapable of communicating verbally any longer, when throughout a lifetime of experiences, you have always used this basic skill to interact with others. Envisage also, when those you are attempting to interact with, cannot understand you because of their reliance on the verbal aspect of communication.
Communication is the glue that holds much of human life together and a central stimulus within the individual life cycle of us all. Through the ongoing development of, and the means we utilise to communicate, most human cultures have the ability to interchange information, concepts, mood and sensations.
Developing the ability to communicate effectively with other persons is one of the most crucial aspects within our life evolution, as we often define ourselves based on how we develop our relationships with others throughout this time.
Functional decline in older people can influence communication when related to sensory aptitude and often, unavoidably, as a consequence of old age, this generates impaired hearing and sight. This regrettably and frequently creates communication difficulties.
Similarly, aphasia may occur, as a pathological result of cerebrovascular accident, (CVA), acquired brain injury, (ABI), acute delirium and/or a cognitive deficit related to dementia. Therefore directly affecting the language centre of the brain and the ability to verbally connect.
People living with dementia often strive to communicate effectively, and this ongoing struggle, at times, may be directly related to the relentless and divergent aspects of living with a condition where verbal interaction inevitably becomes extremely difficult.
Areas that may be considered as impeding communication may include the type of dementia, the progressive stage of cognitive decline, comprehension, insight and judgement, the likelihood of a lowered stress threshold, and/or impaired memory.
Deterioration in verbal communication can be one of the most challenging characteristics of the condition for people living with dementia, and they may experience reduced vocabulary, word finding difficulty, reasoning issues, thought repetition, impaired comprehension, reduced coherence, and may be easiily distracted.
Thus communicating successfully may be at times, enormously difficult.
It could be theorised that the inability to communicate, sometimes, may negatively create situations for people living with dementia, affecting feelings of self worth, exacerbate behavioural expression, upset, embarassment, and frustration, as well as contribute to social isolation and withdrawal.
Subsequently, it seems apparent that one of the most infuriating features of living with dementia, may be the loss or deterioaration of the this ‘verbal’ communicating aspect. Not only for the person living with dementia, but also family and caregivers.
Feelings of alienation and loss of camaraderie my occur, and the person living with dementia may become isolated within their reality, hence live with a sense of lost identity.
It is unquestionably challenging to enter this territory of silent interaction. Our dependence on dialectal aspects and language is so solid and rigid, it takes great determination to fight it.
Some people living with dementia find that dementia conveys experiences and understandings that those of us without the condition cannot even imagine, and furthermore, there are most probably no specific ways for them to express this verbally.
Effective communication is vital in maintaining and reinforcing our personhood, thus the place we hold within the world.
Communication is the transfer of information from a sender to a receiver.
When is communication successful???
When the information is understood by the receiver, in the way the sender intended it to.
Our perception interferes with effective communication because we all perceive things differently. The normal range of barriers, such as perception, effects the way we all communicate.
This interference with the message often results in a communication breakdown.
Communication breakdown often leads to conflict.
“People don’t get along because they fear each other.
People fear each other because they don’t know each other.
They don’t know each other because they have not properly communicated with each other.”
Martin Luther King.
Effective communication plays a crucial role in all caregiving, especially in the provision of care to persons living with dementia.
Knowing how to communicate with a person who lives with dementia can mean the difference between them feeling lonely and remote, or recognized.
As dementia and cognitive decline progresses, the person living with dementia may experience a gradual lessening of their ability to communicate, and thus this may create a situation where it may become difficult to express themselves clearly, and this in turn might isolate a person.
“The ego leaves quite early. I become what I have always been.
It allows me to become quite naughty.
I am unstoppable and unbiddable.
But they park people like me in a warehouse with other people like me, and it diminishes me. I believe more people die of depression and despair than of dementia.”
‘Larry Gardiner’, person living with dementia.
As much as 90% of our communication takes place through non-verbal communication:
Nonverbal communication is particularly important for a person living with dementia who is losing their language skills.
When a person living with dementia behaves in ways that can seem like they are causing difficulties, they are most likely trying to communicate.
Other than dementia, communication can be affected by:
Some changes you may notice in a person living with dementia:
Further Challenges with Communication:
Avoid upsetting arguments, or allowing your own frustrations and anxieties to show – what we put out we receive back!!!!!!!
Use distraction when possible to help overcome frustrations Validate feelings, thoughts, emotion
Be aware that the person living with dementia is functioning the best they can in a reality that is constantly changing – we do not have to deal with such overwhelming pressure.
‘one destructive comment of negativity and discouragement can undermine the self-esteem, take away all hope from the person with dementia, and have a devastating effect.’