The summer before I entered nursing school, our family had planned a vacation to Busch Gardens in Virginia for early August. The first week in July, I underwent major surgery. Unfortunately, post-surgery I developed an infection, which sent me back to the hospital for a week. When I was released, my doctor hesitantly gave me approval to travel, but suggested that I use a wheelchair whenever one was available.

That was a new experience for me. In some ways, I didn’t mind having Randy push me through the scenic park, and I was even able to hold one of our grandchildren (we had three at the time). But I learned an important lesson from being “handicapped.” I was treated as if I could not speak for myself. Strangers, including staff at the park, addressed my husband with questions about me, such as “And would your wife also like something to drink?” I found it disconcerting – as well as demeaning.

That experience comes to mind when people ask me how to communicate with people who have physical or cognitive disabilities. My first response is, “The same way you would talk to anyone.” Sure, there may be special considerations based on each person’s individual situation – especially when dementia is present – but foremost, it is imperative to always express respect and kindness to the individual.

Professor Graham Stokes, a dementia care specialist, suggests keeping a conversation with someone who has dementia “simple, straightforward, and relevant.” He advises avoiding open questions. Instead of “What would you like to drink?” (which presents a myriad of answers from which to choose) ask, “Would you like a cup of tea?” (requires a simple yes or no.) He also recommends talking about memories from yesteryear instead of asking a person what he did yesterday, noting that just mentioning “yesterday” can evoke fear in a person whose short-term memory has taken a leave of absence.

As an illness causes progressive cognitive decline, caregivers are apt to notice some of the following characteristics in conversations: frequently losing the train of thought; using the same words or phrases repetitively; calling everyday objects by made-up words; or inability to speak coherently and logically. Caregivers need to remember that just as it is challenging for them to understand their loved ones, the loved one may also find it difficult to understand what is being said.

A frequent lament of caregivers is, “They ask the same question over and over and over again.” When the exchange becomes perplexing, try to maintain patience. Becoming irritated will only make the person you are conversing with feel more flustered. Calmly convey that you are genuinely interested and will try your best to understand. Encourage him to continue; then be quiet and wait. Try not to interrupt. Use body language and tone to convey reassurance and contribute to a pleasant environment. If the conversation gets stuck, it is okay to speculate as to what your loved one is attempting to say – one guess at a time. If you figure it out, do not make a big deal or resort to a discourteous comment such as, “You should have said that in the beginning.” If she could have, she would have.

Experienced caregivers report that it is best to avoid criticizing, correcting and arguing. These responses will probably do more harm than good.

Keep the lines of communication open as much as possible and as long as possible. There will come a day when the conversation stops, and you will miss it. Until then, patiently share loving thoughts and happy memories just as you always have, keeping the emphasis on the person and not her disability.

Caring Quote: Gracious words are like a honeycomb, sweetness to the soul and health to the body. Proverbs 16:24