Communication Techniques in Late Stage Alzheimer's
In the late stage of Alzheimer's people find it increasingly difficult to communicate their needs and their distress in a verbal way. Caregivers have to find new ways, and at a more basic level, to find activities that relax the person, decrease their anxiety and maintain their wellbeing.
There is evidence that even people with very advanced dementia can benefit through exploring mediums of interaction other than verbal communication. If verbal communication is extremely limited you can still get a level of connection with a loved one. Communication, using the five senses of touch, sight, hearing, smelling, and taste is the key.
Two researchers, Arnold and Amy Mindell, have developed an approach for communicating with people in a coma. One of the things they did was to rhythmically match the patients' breathing, touch and voice. This has been applied to people with dementia such as Alzheimer's, by Tom Richards and Stan Tomandl, two practitioners who trained with the Mindells. They have written a book called, ‘An Alzheimer's Surprise Party' about their communications with Tomandl's father who had Alzheimer's disease. They found he was able to respond to communications by hand squeezing, eye contact, by joining in singing and through expressive gestures.
One of the problems of using this very focused form of communication is that it is extremely time consuming. It also raises a number of ethical considerations. If you are the person initiating the communication how do you know if the other person wishes it to occur at all, or in that form? Would they rather be left alone? Does it mean you are imposing too many of your own wishes/needs on them and do your needs outweigh the needs of the person? Alternatively, given the potential problem of sensory isolation, is doing something better than nothing?
One caregiver said
'I've sometimes been disappointed with mum's reaction....It's trial and error. When I thought something would appeal she just put it to one side. You have to understand that things they may find relaxing on one day they do not the next.'
In her Sharepost, How your Voice and Words Can Affect a Loved One in the Dying Process, Carol (Bradley Bursack) wrote about her belief that her mother responded to her and her sisters words as they kept vigil during her mothers last few days.
It might be very easy to dismiss this as wishful thinking, but it is far better to consider the very real possibility that a connection was retained to the end. In truth we have no real understanding of the effect of speech, music, touch, smells, etc beyond what we have observed. Our observations however are fairly consistent in the sense that the human condition is invariably enhanced by different forms of human contact and the stimulation of the senses. This alone is sufficient reason to try.
More Information about Caregiver Skills in Late Stage Alzheimer's