Connecting beyond the words

In the words of Dr. Dan Siegel “We come into the world wired to make connections with one another, and the subsequent neural shaping of our brain, the very foundation of our sense of self, is built upon these intimate exchanges.”

Creating and being in relationships is a crucial part of our development, our well being and our identity, our sense of self. We relate to each other by communicating with one another and we all can distinguish the difference between simply transferring information and communicating. When we feel seen, listened to, spoken to according to who we are, it is then that we feel another communicates with us – connects with us, meet us and then a dialogue is possible; when there is a common meeting space with others to express ourselves.

John Zeisel, Ph.D., president and co-founder of Hearthstone Alzheimer Care reminds us in his book I’m Still Here: “The person is there. The person knows she’s there. It is up to others to remember and recognize this always. As the disease progresses, other people are the keepers of that person’s personhood. Those who overlook this contribute directly to the person’s anxiety, agitation, aggression and apathy. Acknowledging the person by words and actions reduces these symptoms.”

Feeling we cannot communicate with a loved one, whether they suffer from dementia or not, brings us tremendous pain and grief since we experience it as loosing that person, loosing that relationship. The good news is that can connect and communicate with people suffering from dementia although it may mean to learn a different language, sort of speak, to learn to listen for and perceive in another way as well as to speak with much more consciousness on the impact we have as we do so.

Anna Ortegara Director of Residential Care Services in the Rush Alzheimers Disease Center, Chicago speaks of something we know from our experience with the different people we have me throughout life – that in order to communicate we must find the common language: “People who suffer with dementia are individuals, with individual needs and wants. Furthermore, the disease progression associated with dementia occurs at different rates for different people. The staff and family caregivers must be flexible with their communication techniques, adapting their strategies to reflect each person’s changing cognitive levels and needs.”

Many times, as with children, we “test” aging persons or persons with dementia to show to ourselves they know, they remember. We all have experienced the anxiety of being tested in school, at work, etc and it is not much different with dementia patients. Instead of asking, “Mom, your brother is here. Do you remember his name?” we better say, “Mom, your brother Tom is here.” It is better to avoid testing for skills that are lost and focus on the person’s enjoyment and peace of mind.

A popular saying in Spanish is “Talking is the way people understand each other” and most often when we think about communicating with another, we think of talking. Though the use of words distinguish the way human beings communicate, research has shown that a large portion of what we understand comes not from the words used but from body language (gestures, facial expression, eye gaze) and tone of voice. This is true of communication in general and yet one of the most difficult challenges for those communicating with dementia patients is that of dealing with their progressive lose of verbal communication skills.

In our own experience we know the impact of another person’s gaze, tone of voice and gestures in expressing support, acceptance, and love or opposite feelings. It is not different with dementia patients but rather their sensitivity is heightened as written by clinical consultant Carol Bowlby Sifton “In many ways the dampened rationality of the person with Alzheimer’s disease enhances emotional sensitivity and means that the person tends to communicate more on an emotional level.”

You can find further insights on how to communicate with the person you care for in the bibliography of this post but one thing is certain, the secret lies in connecting to the love and care you feel and in seeing the human being right in front of you.


Communication Tips when Interacting with Dementia Patients:

Anna Ortegara, RN, MS – Communication Strategies:

Dr. Dan Seigel – Midsight: Transform your Brain with the New Science of Kindness (P.10)

Dr. Albert Mehrabian – Silent messages: Implicit communication of emotions and attitudes.

John Zeisel, Ph.D. – I’m Still Here (p.152 – 187).

Carol Bowlby Sifton in association with Canadian Association of Occupational Therapists & Alzheimer Society of Canada – Living at home with Alzheimer’s disease and related dementias: A manual of resources, references and information.

Excerpt can be found at:

Carol Bowlby Sifton – Navigating the Alzheimer’s Journey: A Compass for Caregiving .

Judith M. Richtera, b, , Karen A. Robertoa, b, Donna J. Bottenberga – Communicating with persons with Alzheimer’s disease: experiences of family and formal caregivers. Archives of Psychiatric Nursing. Volume 9, Issue 5, October 1995, Pages 279–285.

Michela Balconi – The Neuropsychology of Nonverbal Communication: The Facial Expressions of Emotions.