Common Alzheimer’s and Dementia Behaviors: Communication Difficulties

    You’re chatting with your husband and sister on the back patio on a beautiful summer evening. The wine tastes divine — even better with some stimulating conversation. Except, for some reason that escapes you right now, your husband is repeating himself and having difficulty finding the right words.

    That’s new, you think to yourself as your sister catches your gaze, as she always does, to note you’re both on the same page. He’s commented on the wonderful weather a few times now. He’s recounted the same story about an office meeting at least twice. And he keeps stumbling over his boss’s name, often resorting to other ways to describe her.

    It’s easy to shrug off these little lapses as a sign he’s just getting older. After all, common aging symptoms don’t always signify something more serious. But he’s typically pretty well-spoken, and these communication difficulties have arisen abruptly. He may be experiencing one of the most common early calling cards of Alzheimer’s and dementia.

    How Does Communication Get More Difficult with Alzheimer’s and Dementia?

    Problems with communication — like most other Alzheimer’s and dementia symptoms and behaviors — grow progressively worse. Being forgetful and tongue-tied with names and words may occur for years before individuals and families seek medical answers. By the end, dementia patients are often completely non-verbal.

    Here’s what to expect by the distinct stages of Alzheimer’s and other types of dementia.

    Early Stages

    Well, you read it in our fictional example above. Your loved one will be alert and entirely capable of having meaningful and productive conversations. In fact, they may go long periods with no communication issues whatsoever, carrying on work responsibilities and daily relationships with a strong vocabulary, comprehension and rationality. 

    But something seems off — even if it’s only sporadic. They may easily lose their train of thought. Discussions may head one way and then veer off course to a different topic. They may seem distracted. They may “lose it,” cutting themselves off mid-sentence when the subject or upcoming words become foggy.

    Some may grow impatient or aggravated. (Who wouldn’t be when more frequently and inexplicably stumbling through their own language?) They sometimes become quiet. And others with multilingual capabilities have been known to revert to their first language.

    Middle Stages

    You may spend many years in these stages with your loved one. Expect much of the same — losing places in thought, misplacing words and names, etc. — but more magnified and growing steadily worse. You won’t be overlooking or rationalizing symptoms here. It’s definitely Alzheimer’s and/or another type of dementia. Your loved one may have already received a diagnosis. Like it or not, they’re well along this path and communication will only become more confounding.

    As their condition progresses, they may instinctively resort to gesturing or describing things to make a point. They might glance to the sky and, not remembering the word “cloud,” use their hands to gesticulate something billowing above their heads. Or, perhaps even misplacing your own name, they might refer to you with a term of endearment like “my lovey,” “big guy” or “handsome/beautiful.”

    While memory indeed plays a key role in communication, it’s important to remember Alzheimer’s and dementia also erode many other cognitive abilities. (As we always say, dementia is more than memory loss.) By the mid-stages of many diagnoses, your loved one could be dealing with: 

    You may notice their discussions beginning to lose a foothold in reality, rationality and logic. They may tell fantastical stories about things they’ve supposedly seen and done — little white lies to fill silence or when they lose the conversation. Some persons living with Alzheimer’s and dementia can even become manipulative, especially when it comes to things they want/don’t want to do. (ex. “But you told me I could drive to the beach!”)

    Late Stages

    Nearing the end, the person your loved one once was may have all but vanished. But rest assured, there’s a beautiful soul in there with plenty to say (if you know how to pay attention)

    They will likely become non-verbal. But they’re not doomed to sit in silence. With some engagement, they can still enjoy family and life’s other gifts — and, just as importantly, effectively communicate their needs and wishes

    In the absence of talking, they may exclusively use gesturing to signify things they want. Pointing toward their mouth or a pitcher of water could indicate they’re hungry or thirsty. Similarly, smacking their lips together may mean their mouth is parched. Using facial expressions, eye contact, grunts or hums they might express:

    • Happiness at seeing a dear family member or friend
    • Pain and discomfort with hot, cold, seating and bedding
    • Desire to enjoy an activity (like taking a walk or watching a movie)
    • Distress from overwhelming situations

    Music and art therapy have even been known to temporarily restore verbal communication, memory and cognition to Alzheimer’s and dementia patients. In a previous blog, we introduced a man named Henry who hadn’t spoken in years, but when given headphones playing his favorite music, he sprung to life and recalled vivid memories of favorite tunes and dances from his younger days!

    Let’s Prepare for Effective Communication with Alzheimer’s and Dementia

    You know communication will become more difficult, especially when your loved one reaches the mid- to late stages. Here are some effective communication strategies for when times get tough. You must plan ahead, that’s exactly what we help individuals and families to do.

    #WeAreDementiaStrong. If you need help, Caregiver Support and Resources, LLC has over 25 years of experience with all aspects of life-care planning including dementia care. We’re happy to guide the process in a caring and compassionate way.