Elder Care: Communication variations

Each time I talk to my aged mother on the phone, I find myself pondering the puzzle of communicating with an elderly dementia sufferer. It's not that my mother doesn't understand what I'm saying. She understands me quite well and can respond appropriately, too. But, because of her short-term memory deficit, which is severe, this can only take us so far. For example, she'll ask me how the weather is where I live. I'll tell her and ask her how the weather is where she lives. We'll go back and forth a few times with pertinent comments on the weather. And then she'll ask me again how the weather is at my place. The same thing happens with any other line of conversation I may start. We can get two or three exchanges in and then she's already forgotten where we started. Thinking she's uncovered a new subject to talk to me about she'll revert to the original question again. And so it goes.

There's nothing wrong with these short, superficial conversations. Before dementia set in, I would talk with my mother once a week or so, and that level of contact and communication was sufficient. At that stage in her life, my mother still had outside contacts, friends and activities which provided stimulation for her. Now that dementia has shrunk her world to a very small space, I find myself struggling to determine for myself what communication means at this stage of my mother's life.

I realized recently that communication per se serves various needs. Obviously, a phone call facilitates the simple transmission of information. But there's more to it than that. There's also the strengthening of the thread that binds us across a long distance. There's the easing of loneliness during a long, quiet day. There's the proof that connections still exist. There's the stimulation to her brain that comes from the need to marshall thoughts and express ideas. And more. Looking at each of these elements independently, I've come up with a few ways to satisfy her needs, beyond the phone call.

1. Hearing a beloved human voice: I confess I don't always have something special to say to my elderly mother. And she's not always able to carry on much of a conversation. Yet I know it's meaningful for her to hear my voice. In between calls, I'll leave messages for her on her answering machine. That way she knows I'm thinking of her, even though we're not engaging in a phone chat.

2. Pet therapy: A brain with dementia is especially in need of stimulus. As I see my mother withdrawing from social activities because she can't follow what's going on, it becomes harder to find ways to engage her. Enter animals. Animals are the gentlest of stimulators. Their presence is non-threatening and non-demanding. They're simply there, willing to be touched, cuddled, played with, watched. A tremendous amount of good comes from this. It's novel, it's fun and funny, it's different each time the animal comes, it provides variety, it stimulates memories. I could go on and on. Many assisted living facilities schedule weekly visits from animal shelters, who bring an engaging assortment of critters for the residents to play with. Perhaps your own caregivers or care manager has a pet they'd be willing to bring along to your parent's house from time to time. How about visits to the zoo?

3. Communication can be more frequent if there's a written option. Take a look at my post about the Presto email printing service. Using this machine and service can broaden an isolated older parent's world immensely. While this system doesn't allow immediate two-way contact, it can provide a platform from which you can dive into more topics of conversation. Use the photograph, or the message you emailed your parent to spark new avenues of communication.

4. Reminiscence is a strong pull among the elderly. But it's not possible to always lead your parent down memory lane in every phone call. How about setting up a long-term memory project, which you can revisit with them from time to time? If your parent is able to follow through on tasks independently, I encourage you to give them a micro-cassette recorder with a bunch of blank tapes, on which to record the tales of their youth, your younger years, whatever appeals to them from their memory vault. It may feel awkward to them to speak into the recorder at first, so you can help them get started by selecting the topic you want them to reminisce about and giving them a list of questions. Or, you can do this in person with them the first time or two, till they get the hang of it. You'll need your own microcassette recorder on which to play their tapes to transcribe them. You could also have a copying service copy the recordings onto CDs for you and your family. This sort of project can span many months and include looking through photographs, getting supplemental information from your relatives...a whole host of opportunities limited only by your own creativity.

Well, these are just a few of the ways in which I've broadened my definition of communication in an attempt to offer and receive more from my contact with my mother. Do you have other ways of creative communication with the elderly parent you are caregiver for, that you can share?