I've had some conversations, lately, about communicating with people who have had strokes or have other problems, such as dementia, that prevent them from communicating in a give and take fashion.
There are many reasons why some people find it difficult to visit people who are no longer "themselves." I have many theories of my own - one of which is that they are aware, on some level, that one day they could be the person others can't communicate with.
Another reason is that many people are uncomfortable with silence. Have you ever been in a group where people are sitting, thinking, and waiting for someone to start talking? There's always someone who "can't stand the silence" and hops in. When we visit with someone who cannot speak, or who has difficulty pronouncing words or finding the right words to use, it can be very uncomfortable to sit in silence. It's human to want verbal communication, to some degree.
My uncle had a type of aphasia, an inability to find the right "label" for things he knew well, brought on by a series of strokes. I've used a classic example of his problem in Minding Our Elders and I refer to it when I speak, because it shows so well the frustration, on both sides, that this inability to communicate can cause.
In this particular incidence, Uncle Wilkes keeps telling me to fix his "magazines." He kept a neat stack of magazines on his night stand, so I kept straightening them. He got more and more angry, screaming, "No! Fix my magazines!"
After touching one thing after another as I asked, "Is this what you want fixed?" I finally opened a drawer and saw his razor. I said, "Does your razor need fixing?"
He shouted, "Yes! Fix my magazines!"
Now, this is not a man who ever had a problem with words. In fact, he'd been a voracious reader, and he loved the game Scrabble. It was the damage to his brain, caused by the strokes, that made finding the right word hard, and in some cases, impossible.
Sometimes, however, people become mute, or nearly so. Or they find trying to form words just too wearing. Maybe they just don't feel well enough to struggle with keeping up their end of the conversation. Do you just leave? Do you try to drag out a conversation? What is right?
As with all caregiving, each person is different; each day is different; each circumstance is different.
What we caregivers need to remember is that there are many ways to communicate. We can communicate through touch. Does your Mom like her hair brushed? Let her relax and brush her hair. Maybe put on some music that she likes while you do it.
If the person is alert, but it's too stressful to try to communicate, just sit with them and watch their favorite TV show, or play music and do crossword puzzles, commenting on how you are progressing. Your presence is what matters. It's about much more than conversation.
Is the person just lying there, staring at nothing? Human touch is a necessity of life. Brush back a stray hair, hold his or her hand, rub lotion on dry limbs, read to the person out of a cherished book, or a religious book from his or her past. You can speak, like speaking a monologue, about fond memories that you and this person share.
The sense of hearing is thought to be the last thing to go. As my sister and I sat with our dying mother, we talked about our mother's deceased sisters. We even looked through a photo album, exclaiming about different photos and memories they brought back. It seemed that Mom understood, even as she lay unconscious.
The thing about communication is that more than words are involved. Think hard about what would please this person. Keep beloved objects near by. Then use your memories about what they loved best to guide you. You can communicate, even if they - or even you - don't utter a word.
Published On: October 11, 2007