Joan Rivers often began her comedy routine with the comment, “Let’s talk…” Often that is how caregivers for those with Alzheimer’s Disease and related dementias try to communicate with their loved ones. Unfortunately, though, sometimes those for whom we offer care can no longer use words, or are living in a reality that isn’t ours.

As Alzheimer’s Disease, for example, progresses the ability to talk diminishes and, sometimes, vanishes. Trying to talk and expecting a verbal response sets the stage for frustration for the caregiver and failure for the one living with the disease.

Also, those with some form of dementia often believe that they are living in some time past (often long past), not the reality that we know today. In their minds they may be living in a time when they were very young, perhaps before they were married or had children. When they look in a mirror, they may see a 20-year old just beginning adulthood. When you look in their face you may see an 80-year old approaching the end of adulthood. It is a challenge to talk in that scenario. Caregivers often try to pull their loved one into today’s reality by saying things like, “don’t you remember, mom?;” or “don’t you remember when you worked at Bethlehem Steel?”; or some other question designed to re-orient the one with dementia to what the caregiver believes is the real reality. For the one with dementia what is being remembered in their mind and who they are seeing in the mirror is the real reality for them. To try to pull them into the caregiver’s reality is both futile and frustrating for all involved.

So what do caregivers do? Surrender to the reality of the disease process and stop communicating? No! Instead, you can enter the reality of your loved one. You can talk without expecting a response; or hold a hand; or give a hug without saying a word; or talk to your loved one about their day even though they may be remembering a day that is long ago and far away.

The keys to communicating with those with dementia are love, understanding, patience, and a willingness to lay aside our reality so that we can enter into their reality. We can remember Paul’s words to the Corinthians and recite them as a kind of mantra:
Love is patient, love is kind, it isn't jealous, it doesn't brag, it isn't arrogant, it isn't rude, it doesn't seek its own advantage, it isn't irritable, it doesn't keep a record of complaints, it isn't happy with injustice, but it is happy with the truth. Love puts up with all things, trusts in all things, hopes for all things, endures all things. Love never fails. (1 Corinthians 13:4-8a, CEB)
Communication with our loved one with dementia may be frustrating and difficult. It is possible, though, if we lay aside our need to be correct about the day and time and other details of our realities and replace those expectations with the love of which Paul writes, entering the world of our loved one.

Enter the world of your loved one. Talk to him. Laugh with her. Hold his hand. Give her a hug. And keep close Paul’s words as your motto: “Love never fails.”

Suggested resources:
• http://www.caregiverstress.com/family-communication/
• https://www.alz.org/care/dementia-communication-tips.asp
• https://www.alz.org/care/
• http://www.helpguide.org/articles/caregiving/support-for-alzheimers-and-dementia-caregivers.htm
• https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors
• https://www.alzconnected.org/