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Non-verbal Communication Matters
Humans are born with an innate ability to form social bonds. From birth on, we understand facial expressions, cry for attention, warm to cuddling and touching, find comfort in music, and know when we are loved. After birth, we mimic others to learn language and other skills. When we are young, we have an enormous capacity to absorb new information.
It is important for dementia caregivers to understand this sequence because the hardwired skills we inherit at birth are maintained throughout most of the dementia journey, but the cognitive and functional abilities we learn after birth tend to deteriorate in reverse order to that in which they were developed during childhood. This means that as the disease progresses, higher cognitive functions like memory are usually lost first, while more basic functions like motor skills are maintained longer. Nurses in Intensive Care Units believe that hearing, which begins before birth, is typically the last of our senses to be lost. (A personal aside: The night before Gayla died, she was completely unresponsive. I stood next to her hospital bed and tearfully reread old love letters to her, hoping she heard. I’ll never know, but it at least it helped me.)
Dementia affects emotions and behavior as well as cognition. In the early stage of Alzheimer’s, the most common deficiencies we notice are repetitive questions, short-term memory loss, misplacing objects, and difficulty with word and name recall. But there also may be an increase in irritation and anxiety. During this period, effective communication starts by being patient and empathetic. Live with your loved one in the moment. Be positive and set the tone. Provide simple choices. Recall fond memories. Simplify everything. Avoid questioning and arguing. Never say “Don’t you remember?
As the disease progresses, communicating becomes more challenging. As the ability to absorb information fades, new information is not properly processed and long-term memories becomes inaccessible. Deteriorating word recall and confusion result in an inability to carry on coherent conversations. Decision making becomes overwhelming. Declining brain functions, like organizing thoughts and exercising impulse control, cause changes in behavior. Social filters, reasoning, and vision decline. Time loses relevance. Emotions don’t match the situation.
Imagine for a moment, what your life would be like if you didn’t understand the conversations going on around you and your mind was a jumble of mixed-up thoughts. How would you find happiness or even minimal comfort? It’s a lonely and scary world, and this may explain the anger that some people express. But we can help!
As the world of rational thinking declines, the world of feelings and emotions supplants it. When comprehension and rational discussions are no longer viable for our loved ones, we can connect through those hardwired capabilities that are still alive. We can slow down, be active listeners, and focus our energy on the moment to confirm our sincerity. Each time we meet, we can smile and use eye contact to show we are happy to be together. We can connect on a deeper level with gentle touching, holding hands and giving neck and shoulder massages. We can play their favorite music or walk outside to share the sunshine, flowers, moonlight and trees.
By using non-verbal communications and encouraging creative skills our loved ones enjoy, we reconfirm our love. A dementia diagnosis may be notice that the most exuberant days of our lives have passed, but the opportunity to make each day as good as possible never disappears.
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