Are you ready to experience the best possible relationship with your senior loved one with dementia? Turns out it’s all in how you communicate. In this episode of Senior Living LIVE!, The Arbor Company’s Vice President of Memory Care, AJ Cipperly, helps us understand how to talk to a loved one experiencing memory loss.
From diving into the parts of the brain that engage in conversation and prioritizing feelings over facts to understanding the right way to ask questions, AJ explores all the ways communication can not only make your senior family member feel at ease in their daily lives, but also strengthen your bond and ensure miscommunication is minimized. You’ll find how just a little empathy and thoughtfulness can go a long way in making a positive difference.
Video Transcript
Hi, everyone, and welcome to an episode of Senior Living Live. We are here on location at The Arbor at Delray in Delray Beach, Florida, and I am so excited. Joining me today is The Arbor Company's vice president of memory care, AJ Cipperly. Thank you so much.
Absolutely.
Communicating With a Loved One Living With Dementia
I know you're very busy, so we're very happy to have you here today. And we have a great topic, communication. Very important for everyone. Even more important for loved ones who are living with dementia. Can you kind of talk us through, you know, how important it is to be mindful of how you're communicating with a loved one who may be living with dementia.
Absolutely. I mean, communication is how we relate to one another. It's how we share information with each other. And with dementia, the parts of my brain that are involved in communication and language are changing. And it's important to know how they're changing in order to better support the person that you love and that you're caring for in a way that they can still understand and that you can understand them and you can still have a good relationship and communicate the things you need to communicate.
So for an example of that would be, the parts of the brain that are involved in communication and language are your temporal lobes. They're on the side of your brain. And there's two different sides. With dementia, the left side is always affected first. We don't know why, but the left side of the temporal lobe is always affected first. The left side of your temporal lobe is where all of our formal language skills are housed. So our ability to comprehend, our ability to produce speech, and our vocabulary. So one of the first things that we start to see happening with dementia is word finding issues. I mean, that's part of normal aging too. Like, all of us have word finding problems. Right? We can't think of a word and, oh, you know, that thing that you know, you write with it. So I'm able to describe the item enough that you know what I'm talking about. But with dementia, it becomes more vague. And so I'm saying things like, I'm looking for that thing. You know, that thing can you help me find that thing? And and and you know that place we go and, you know, it's down there. Well, so my language is very vague and I'm not really giving you enough information for you to figure out what it is I'm talking about. So one of the things, one of the tips that we share is one of our habits when somebody says I'm looking for something. What do you, if I tell you what I'm looking for something, what are you gonna tell me?
What are you looking for?
Yeah. Well, you've just asked me for the thing I don't have. I don't have the word. If I knew what it was, I would have said the word. So instead of saying, well, what are you looking for? Try this. Say, oh, well, can you tell me more about it? So that gets me talking. Maybe I could come up with some more descriptive words for you to be able to figure out what it is that I'm talking about. The other thing you could ask me is, well, can you show me what you do with it? So I might not have the words, but I could show you, you know, maybe this or this. I could give you some visual cues that might help you understand what it is that I'm wanting or looking for. And the third thing you could try is, well, can you take me to the place where that happens? So if it's a place, we could go to that place. Maybe it's the bathroom. Maybe it's the kitchen if I'm wanting something to eat or drink. So that's just one simple tip of, you know, when a person's losing the words, how we can help.
The other thing too is you don't always wanna jump in if you think you know the word. If I'm trying to come up with a word and you know exactly what it is I'm trying to say, sometimes that might make me react. So if I say, well, I'm looking for a, and you say a pencil. Of course, I'm looking for a pencil. Don't you, why are you. So I might have a reaction. So instead, what you might try is, oh, well, AJ, are you talking about a pencil or a pen? Let me tell you what it is instead of you telling me. Because what you're doing in that moment is you're just reminding me of the loss. I couldn't think of the word. I don't have the word. So give me the opportunity. Give me a choice. Oh, do you mean this or this? And let me tell you what I mean.
The Physical Aspects of Engaging with Individuals Living with Dementia
That's fantastic advice. Can you talk a little bit about, you know, actual the physical part of having a conversation with someone who may be living with dementia? We've talked about it in different episodes and webinars before, but it's always something I find so interesting of, you know, having actually coming at them from the front. Can you kinda explain that in a much better way than I just did?
Well, I mean, a lot of that is, you know, the changes that are happening with visual processing. So I'm losing my peripheral vision. So if somebody approaches me from the side, I'm not gonna see them. You have to approach me from the front, and you have to make sure that I have you in my sights. Right? That I'm paying attention to you visually. Because if you're to the side of me or behind me and you're speaking to me, I don't know that you're speaking to me. So making sure that you're in front of me, that you're making eye contact. Because if you're not looking at me, do I know that you're talking to me? Plus, people living with dementia pay more attention to how we look and how we sound more than actual words we're saying. Because I'm not good at interpreting the words, so I'm really paying attention to your facial expressions, and I'm paying attention to the tone of your voice and the volume of your voice to see if I can figure out what it is you're trying to communicate. And so that's why sometimes we get an answer that we're not expecting. So, you know, if the words you're saying don't match your tone or your facial expressions, I'm gonna be confused. Or a lot of times what happens is we don't realize that people can still pick up on volume changes. Right? And so if you ask me a question, maybe I don't understand. And so I'll say, what? Huh? And so what are you gonna do?
Repeat it.
You're gonna repeat it, but how are you gonna repeat it? You're gonna repeat it louder and probably with, you know, greater volume and intensity. So for example, if you're saying, well, AJ, do you wanna come have some dinner? What? Huh? AJ, do you wanna come have some dinner? So for me, living with dementia, I may not understand the words. I know you got louder, and your face didn't look real friendly in that moment. Like, we can't really be loud with a person and smile at the same time. It just doesn't happen. And so if I don't understand the words, what I'm gonna think is, what? She's mad at me? What did I do?
Right.
And my answer to you probably will be no. Because I don't, why are you mad at me? I don't wanna be with somebody who's mad at me. You simply wanted to know if I wanted something to eat. So a lot of times we assume it's a volume issue and we repeat what we say when it might be a comprehension issue. So another good tip is, in addition to, you know, facing the person, eye contact, is slow down. Give me a chance to respond. Give me a chance to process what you said and form an answer. And then if you're gonna repeat yourself, here's another tip. Say it the exact same way. Because typically what we'll do is we'll say, Mary Cate, do you wanna come have some dinner? You don't answer. You say, what? Huh? And then I'll say, do you wanna come eat? Well, the challenge for you is you're trying to process the first thing I said, and I went and gave you something completely different. So instead, it might look and sound like, hey. Do you wanna come have some dinner? Wait. Hey. Do you wanna come have some dinner?
The Importance of Visual Cues
Now here's another tip for you. If you really wanna support the person and help them be successful, add in a visual cue. Hey. You wanna come have some dinner? Because even if you don't hear me or you don't understand, whether it's a hearing or a comprehension issue, I've given you two opportunities. You wanna go eat? And I've used the words. So, again, people with dementia pay more attention to what they're seeing. They can interpret visual cues more than they can the words.
Yeah. Wow. So helpful, because you don't you don't think of that. You know, you get frustrated easily or you just don't know. And this information can go such a long way. Is there anything else before I let you go, that, you know, you wanna leave us with or any other tips just when having that good communication with our loved ones who are living with dementia?
Well, I mean, I think one of the important pieces that a lot of people don't understand is the comprehension challenges that a person with dementia is living with. So I mentioned that left temporal lobe is part of comprehension, and I'm losing that ability. So it's estimated that early on in the disease, early on. And so I may not even have an official diagnosis at this point. But early on, a person's only getting about three quarters of what we're saying. And three quarters of something, I mean, that sounds like a lot, but isn't enough. Early in this, people will miss at a four. How before you got, do you think?
What?
Early in this, people will miss out of four. How before you got, do you think? You don't understand?
No.
Let's try it this way. Early in this disease, people will miss one out of four words. How long before you got lost, do you think? I just skipped every fourth word.
And I thought you were speaking another language.
Yeah. And so that's early on. So you can imagine as the disease progresses, a person may only be understanding two out of four, one out of four, and then maybe no words at all. And so that's why it's important if we're supporting a person who's living in the early stages, we need to slow down. We need to make sure they're getting what we're saying before we move on to the next thing. If we're supporting a person who's living further along in the journey of dementia, we need to stop using so many words and use more visual queuing to get our message across.
Wow. Fantastic. Thank you so much for sharing this information with me and our viewers too. I know it's a crazy week here, so, thank you. We really appreciate it.
Alright, everybody. That is it for this episode. If you're interested in learning more about dementia resources or anything related to senior living, you can find more episodes like this one at seniorlivinglive.com. Thanks everyone!
