How to communicate with someone who has a cognitive impairment – Part 2
I would again like to thank Kate Smith from Memory Matters some of the information for this blog.
It is still important to note that no two people with a cognitive impairment will communicate in the same way, but here are some more ideas that will hopefully help.
People with dementia can retain some motor skills that those around might have thought that they had lost. In general, people lose their fine motor skills, so their dexterity becomes impaired for wide-ranging things, however they still might retain muscle memory for something that they did a lot when they were younger, which is why people can play the piano, even if they have trouble getting dressed and doing up buttons for example! This can be helpful with doll therapy and pet therapy, as the person with dementia is used to rocking a baby or stroking a pet. The moments are familiar to them and feel safe, so they will relax.
One third of our brain relates to processing visual information, so if this part of the brain is damaged, then the person will have difficulty in some way process or misunderstanding what they see. This can lead to what appears to be difficulty in walking, if for example they perceive lines in carpet as snakes on the floor or dark carpet / mats as holes, which they need to step over. They might also have difficulty in recognising people visually, so a prompt, such as giving your name and relationship is helpful.
The person with dementia can lose insight into not just their condition, but lots of other things to. They might act in a way that is considered socially inappropriate, such as greeting everyone like they are your best friend or spouse. They might hold hands with someone, as it is comforting to them, without the insight into what is socially acceptable, they are behaving in a way that they want and is helpful or comforting to them. In general, unless completely inappropriate, then it is easier for them if the people around them go along. I have had clients who have hugged and kissed me like I was their child and have always appreciated that it was a lovely, warm and kind way to greet me! It is nice to be liked!
Communication is relevant both ways, communication to tell someone something and communication when someone is telling you something. The loss of the ability to communicate can be in both directions, but it could be worse in one than in the other. People can have word finding difficulties, which can be frustrating, as they know that they know what they want to say, but have trouble remembering the specific word, so “pork” could become “bacon” or “pig” instead or they might use gestures to try to explain themselves.
Receptive language is about someone’s ability to understand what is being said to them and if this fluctuates the person can be thought of as having selective hearing! It might simply be that their ability to understands fluctuates, like the rest of their presentation. So, the person might need the carer to use simple language or different language. They might need to use gestures or other nonverbal communication, anything that involves touching the person with dementia should be appropriate, usually touching their hand is considered appropriate, but what that is, depends on the perception of the person with dementia.
What is important is that the person with dementia feels safe with you, if nothing else, be the smiling safe person!
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