Lost for Words
George, diagnosed with dementia, recently arrived on the hospital ward for assessment. He cannot express his needs with words. Every so often he paces up and down the corridor, stops at the door wanting to go out. He is asked repeatedly to come away from the door, which only increases his frustration.
Finally one member of staff talks to him in a reassuring way, takes him gently and walks with him to the bathroom opening the door. As soon as George sees the toilet he seems relieved and mumbles something that sounds like ‘Thank you’. He is then helped to feel comfortable again.
George is one of so many older people who are literally ‘lost for words’ as a result of living with progressing dementia. This is a challenge for him and for all those who love him and care for him. Until recently, George was a man who loved gathering with friends and family, loved debating the latest news in politics or sports, or simply reminiscing about times past. What now? Words, which have been the most important pillar of communication, only rarely manage to cross his lips and it is difficult to know what spoken words mean to him.
He is trying out other ways of communicating, but will he be understood?
before words become possible………
If you have ever cared for a baby in the first months of her life, I am sure you would never dream of thinking that she is unable to communicate, just because she hasn’t as yet any words to describe her feelings, her needs, her experiences. Quite the contrary; you will have experienced first-hand what a determined and powerful communicator your little baby is, without saying a word. Moreover we know that strong relationships start building up long before the first word is spoken.
How does she manage? She uses every available part of her body – hands, feet, face, eyes, vocal chords etc – just as we all do.
How do we manage to understand? Very naturally we pay attention to the whole of her being. However as time goes on, and the toddler learns to speak, we begin to pay less attention to the rest of her body language although, of course, it’s always there.
when words don’t come……
For some children words may always be difficult or they may never come. This may be because the child grows up with a learning disability or some other condition that makes speech difficult or impossible. Sometimes ‘sign along’ or sign language can compensate for the spoken word.
However when this is not possible, perhaps because there are accompanying physical disabilities, then other ways of communicating will need to be found. It is then often those living in closest proximity who will learn to understand and so enable and foster different and effective ways of communicating.
……or when co-ordination is difficult
Rita is in her eighties. She is on a continuing care unit as she lives with a very advanced stage of dementia. She spends her day in a specialised armchair. She cannot talk, although she does make some sounds. She cannot care for any of her needs, so her day is based on a routine to make sure her basic physical needs are met. Members of staff who have worked with her for a long time also observe her very carefully to detect any signs of discomfort or distress in her facial expression or her body movements.
Rita, of course, also has emotional and spiritual needs. She reacts to touch. Sometimes when I hold her hand she squeezes it slightly and holds on to it. Her eyes often wander aimlessly around and she seems unable to fix them consciously on what she wants to look at. Sometimes we sing with the patients. Regularly it happens that if I approach Rita, looking at her and singing gently in front of her for quite a while, she ends up meeting my eyes and a big smile spreads over her face: a very moving encounter.
Rita’s story tells us something about how much emotions and feelings remain an essential part of her life. She continues to be appreciative of human encounters and is occasionally well able to express this with her hands or face.
Like George’s story, like in the life of the baby, the toddler, the person with severe learning disabilities, it is amazing to experience over and over again how much we human beings communicate effectively way beyond words.