"Every life deserves a certain amount of dignity, no matter how poor or damaged the shell that carries it."

– Rick Bragg

Dignity in CommunicationIt can be easy, when your loved one appears to be a shell of the vibrant human being they were in their youth, to treat them with less respect or awareness of the human being that they still are. Even if they cannot express themselves in the way that they used to, the person you love is still in there and deserving of being treated with respect and dignity.

Alzheimer’s Disease and other dementias gradually diminish a person’s ability to communicate. However, their desire to connect doesn’t diminish at the same rate.

The first visible signs of reduced communication abilities due to their dementia might be:

  • Difficulty finding the right words
  • Using familiar words repeatedly
  • Describing familiar objects rather than calling them by name
  • Easily losing a train of thought
  • Difficulty organizing words logically
  • Reverting to speaking a native language Speaking less often
  • Relying on gestures more than speaking

More Ways to Preserve Dignity Beyond Communication

  •  Focus always on dignity. They are not just a dementia patient. They are a mom, dad, uncle, aunt, friend, cousin, human being.
  • Use preferred names when addressing them.
  • Knock before entering their personal space.
  • Sit when feeding them or helping with other tasks.
  • Honor their clothing choices.
  • Ask before changing music or TV shows that might be on when you enter a room.
  • If they must use a catheter bag, cover it to keep it from being a focal point for visitors.

Meet them where they are but try not to finish their communications for them unless they ask for help. Some tips to help you grant them dignity in your conversation include:

  • Don’t make assumptions about someone’s ability to communicate because of an Alzheimer’s diagnosis. The disease affects each person differently.
  • Don’t exclude your loved one from conversations or assume they are not listening.
  • Speak directly to them rather than to their caregiver or companion. Allow them the dignity of making the decision to defer to their caregiver.
  • Take time to listen to them express his or her thoughts, feelings and needs however long it might take. Don’t interrupt unless help is requested.
  • Ask your loved one directly what they are still comfortable doing and what they may need help with. When they are early in their decline discuss with them whether they appreciate or are frustrated when you complete sentences for them.
  • It’s OK to laugh. Sometimes humor lightens the mood, can open up memories and neural pathways to make communication easier.
  • Don’t pull away; your honesty, friendship and support are important to your loved one. As difficult as it might be for you to see them in cognitive decline, it’s so much more difficult for them to be the ones in the middle of it. Don’t assume they are completely unaware of the challenges they face.

As their communication abilities decline in later dementia, non-verbal communication becomes more meaningful:

  • Maintain eye contact with your loved one to show them that you are engaged with what they are saying or communicating non-verbally.
  • Ask questions but only one at a time. Yes, or no questions may be easier than open-ended questions as the disease progresses. They can nod or smile for yes. For example: “Would you like a cup of tea?” Rather than “What would you like to drink?”
  • As you notice that they are having challenges recognizing people, make a point of introducing yourself each time you enter the room. It’s not their fault if they don’t recognize you and can be a source of frustration or embarrassment.
  • Avoid baby talk or diminutive addresses like Sweetie or Darling. Use the name they prefer to be called.
  • Be prepared to repeat yourself. If you expect to have to do this, you will reduce your own frustration with having to do it. You are showing respect to your elder if you are prepared to communicate in the way that they need you to.
  • If you don’t know what to say, sometimes it’s enough to simply sit with them and hold their hands. You can listen to music from their childhood or read to them from favorite books.
  • Pay attention to their emotions more than the specific words they are speaking. You will know if they seem agitated or happy. Respond to the emotions. Especially if they are frustrated or stressed, words will be more difficult for them.

Above all, they are human beings. If you continue to think of them as the person you have always loved, instead of the disease that has overtaken their brains, you will instinctively treat them with dignity and respect. They have earned that over a lifetime.