By John Skelton with excerpts from Teepa Snow and her Positive Approach to Care PAC
Communication can be challenging. There are so many things that can get in the way of proper communication; people speak different languages, or maybe we speak the same language but some words mean one thing to one person and something very different to someone else. Perhaps you received the message I’m giving in a way that was not intended? Maybe I misheard what you said. There’s always the potential that something was lost in translation. There are many things that can get in the way of effective communication when we have healthy brains, but what happens when one of us is living with dementia?
When a person is living with dementia, whether it’s Lewy Body, Vascular, Alzheimer Disease, or something else, that means at least two parts of their brain are failing. In many of these forms of dementia, the left temporal lobe is affected early. This means that the person will have more difficulty processing the words you are giving them, knowing what to do with those words, and then providing words back to you. This can certainly make things difficult for both of you, but that’s not all. Another form of communication that is changing is communication within the body of the person living with dementia. With a healthy brain, your body sends signals to your brain that your brain then interprets as pain, thirst, hunger, pleasure, or something else. Your brain has the map of your body laid out and knows exactly where these messages are coming from.
With dementia? Yeah, that changes, too.
This means that a person’s leg might hurt but when the message was sent to the brain, it never made it. Or maybe the message was sent to the brain, but the map of the body wasn’t working, so the message was sent to the wrong place. Now, the person living with dementia is uncomfortable, but might not be able to tell you why. Did you know that according to several studies, following a hip fracture, people living with dementia get about half of the pain management medications that someone without dementia receives? Half! Is it because a hip fracture hurts less if you are living with dementia? Of course not. However, there is a very good chance there is at least one, if not two or more, communication breaks happening here.
Either the person living with dementia had missed messages from the area of the body in question, their brain misinterpreted the message, they were unable to form the language necessary to respond, or they didn’t understand the question from the caregiver. Wow! There are a lot of potential roadblocks popping up here. Hmm, well the pain and discomfort is still there, so what happens next? As the pain and discomfort increase, people become more agitated. When caregivers or bystanders don’t understand what’s happening for the person in pain, particularly someone living with dementia, this is often referred to as a behavior – as if the person is choosing to act this way for no reason. Unfortunately, what often happens next is that caregivers will try to correct the behavior with antipsychotic drugs or other disciplinary tactics. None of this addresses the root cause of all of this, which is the pain or other unmet need that the person living with dementia was not able to express in that moment.
Clearly this isn’t ideal for anyone involved with this, but – what can be done differently?
Senior Helpers and our Senior Gems Training of Caregivers and family alike can go a long way in helping those living with Dementia to live a full, happy, and safe life.