Communication is complicated. It can include the ability to speak, the ability to hear, and the ability to understand the words that were said. Think of the husband who lost his ability to speak in a stroke; the mother with throat cancer; the father who has grown deaf over the years.
I was staying with my own mother recently, who now has Alzheimer’s, and she is helping me rediscover the art of communication. One of the great ironies of growing older is that we can have multiple challenges going on at the same time. On this occasion, her hearing aid had accidentally been washed, and was no longer working. She already has a hard time understanding what words mean, and this made it even harder.
It’s probably best in any situation to be in the same room with the person with whom we’re communicating, facing them and speaking clearly. With a broken hearing aid, it became especially important.
It soon became apparent that she was queuing off of my actions. This simply means that she was watching me to try to figure out what to do. She wouldn’t eat unless I sat down to eat as well. She didn’t get ready for bed until I put on my pajamas too. This isn’t unusual. We all do a certain amount of watching others to make sure we are doing the right thing. We do this at school by watching the other children, how they dress, determining what is considered “cool.” For someone who is confused on many levels, watching others is their best tool for coping in their environment.
But it’s important to realize that even this type of communication is a two-way street. I learned from noted geriatric psychiatrist Dr. Nestor Praderio that I needed to watch her actions, and try to get the meaning behind her words, as well. It’s like the time my mother-in-law, who also had Alzheimer’s, told us that she was going to have 92 babies as she shyly patted her stomach. She had gall stones. She knew something was different and painful, and this was her interpretation. Of course, we didn’t realize what she meant until she needed immediate treatment. By that time, we felt horrible that we had missed the clues she was giving us.
This time, I was better prepared. When my mom asked me what time it was over and over again, she was really wondering what she was supposed to be doing. When she asked me how long it would be until the rest of her family returned from vacation, she was communicating that she was worried that perhaps her family wasn’t coming back. We had hidden conversations that we both had to decipher. Perhaps this is what she was saying to me:
“When are they coming home?”……… “I’m worried. I don’t see the people I recognize.”
“You have so many things.”………. “All of the clutter on the counters and dresser confuses me. There are too many things to look at, and too many choices.”
“I don’t want to take a bath.”…… “I get cold unless the room is warm. I don’t want the water too hot or too cold.”
“Do you want a cookie?”……”I want a cookie. I’m hungry.”
“Where did you learn to do that?”…….”I used to know how to do that.”
“No! I don’t want to.”……..”I can’t remember how.”
“Sometimes my brain does funny things.”……..”I know something is wrong with me.”
“Are you my sister or my daughter?”…….”I know you are family, and you are someone close to me.”
“I love you.”…………”I need to feel loved.”
It was at these times that the most basic communication worked the best – a smile and hug …. and perhaps one of those cookies.
Carol Zernial is Vice President of Community Relations for WellMed Medical Management and Executive Director of the non-profit WellMed Charitable Foundation. A noted gerontologist, Ms. Zernial also serves as Chair of the National Council on Aging Board of Directors.