Family Caregivers Communication Class — Part 5: How to Talk with Aging Parents When They Can’t Speak

This is Part 5 in a series. Please see the bottom of this article for a link to the first four parts of the Family Caregivers Communication Class.

We take talking with our parents for granted . . . until our aging parents can’t speak any longer.

My mom gradually stopped speaking and since October 2007 she only utters a few words or phrases occasionally. When she does speak, the words are often unintelligible, don’t make sense, nor relate to the conversation around her. I didn’t know it at first, but this medical condition is called aphasia. I thought it was just part of the progression of her Alzheimer’s disease.

What My Instincts Told Me To Do

As my mom became less talkative, I found myself looking for different ways to connect with her. These are some of the techniques I’ve used successfully:

Have eye contact with your aging parent before you speak. This helps my mom to focus on my words and facial expression.

Talk slowly, enunciate clearly and keep your sentences short. Put only one thought into a sentence. When I do this, Mom seems to follow some of what I’m saying.

Aphasics haven’t lost their intelligence, just their ability to speak. They are like a baby who understands and responds to language even before they can say words, phrases and/or sentences. I think my mom understands more than she can express.

Be inclusive when you speak. I tell my mom about all family news, events and contact from friends far and wide. I’m not even sure she knows who I’m talking about due to her memory loss, but I share happy things with her all the time. In my heart, I think she understands. I also avoid sharing bad news, either local or global, because why upset her? In my opinion, it’s just not necessary.

Add nonverbal communication into your conversations. Many times I “cuddle her up” which means lots of hugging, kissing, and massaging. Even if we don’t talk, she can feel my love for her through the sense of touch.

Watch your Golden Oldie closely when talking with them. While they may not verbalize, be alert for other ways they are “speaking” to you. My mom will nod ever so slightly or move her head side-to-side in response to a simple “yes” or “no” question, such as “Do you want to look at this book with me?” Sometimes she’ll look away, and I take that as a “Not interested” response. She also communicates in different ways with her eyes — raising her eyebrows at people at times, or closing her eyes tightly when she doesn’t like something.

Even if the words are gibberish, the inflection in her voice makes me think she’s saying something important to her. I reply in a similar tone to reassure and encourage her. Sometimes I say, “Mom, I didn’t quite understand you. Can you repeat it please?” But she isn’t able to.

Bring visual aids to enhance your “conversations.” I often bring cards I’ve gotten in the mail, some flowers, a stuffed animal, picture books, or photos (both old and new) to share with her and focus our attention on together. Seeing something she likes will spark a few words at times.

What I’ve Learned About Aphasia

Aphasia is an impairment in the ability to speak and understand others, and people with aphasia may have difficulty reading and writing, too. While it is most common among older people, it can occur in people of all ages, races, nationalities and gender. The most common cause of aphasia is stroke; about 25-40% of stroke survivors acquire aphasia. It can also be a result of head injury, brain tumor, or other neurological causes.

Aphasia affects about 1 million Americans, or about 1 in 250 people. More than 100,000 Americans acquire the disorder each year. As in my case, most people have never heard of it until they are facing it with a loved one.

There are many types of aphasia. Some people have trouble speaking, while others have a hard time following a conversation. In some people aphasia is fairly mild and you may not notice it right away. In other cases it can be severe and will affect all communication skills — speaking, writing, reading and listening.

Through my research I’ve found the additional tips below from the National Aphasia Association for communicating with our aging parents who have aphasia:

• During conversation, minimize or eliminate background noise (such as TV, radio, other people) as much as possible.

• Other modes of communication can include writing, drawing, and gestures.

• Give them time to talk and let them have a reasonable amount of time to respond. Avoid speaking for the person with aphasia except when necessary and ask permission before doing so.

• Keep communication simple but adult. Reduce your own rate of speech. You don’t need to speak louder then normal, but do emphasize key words.

• Don’t talk down to the person with aphasia. Their intelligence is still intact; don’t let others assume they are mentally retarded or mentally ill.

People who have aphasia as a result of a stroke or head injury may recover their ability to speak and communicate in time.

Aphasia and Alzheimer’s Disease

The impact of aphasia on relationships varies from family to family. My mom’s aphasia is part of her progressive brain deterioration due to Alzheimer’s disease. She will never recover her ability to speak, because the ideas and thoughts that she could express are disrupted along with her ability to communicate.

When my mom speaks I wonder if she’s thinking “What the heck happened to me?” because her words don’t come out right. Or does she think she’s communicating perfectly clearly? I’ll never know the answer to these questions. She doesn’t appear frustrated, so in my heart I hope she’s not.

What has been your experience caring for someone with aphasia?

What are your tips on how we can better communicate with them? Please write them in the comment section below.

Click here to read the first Four Parts of the Family Caregivers Communication Class.

Related posts:

• Family Caregivers Communication Class — Part 1: Think Before You Speak
• Family Caregivers Communication Class — Part 4: Talking with Hearing Impaired Aging Parents
• Family Caregivers Communication Class — Part 3: Dealing with Pessimistic Aging Parents
• Family Caregivers Communication Class — Part 2: Speaking Easily About Difficult Topics