Tag: aphasia

Dementia and English as a Second Language

Are you enjoying my blog posts? Grab a free download of one chapter from my audiobook here and also receive any future helpful tips and posts right to your inbox! I’ve had a number of clients and residents over the years lose their ability to speak. Sometimes this happens early in the disease process, and sometimes it happens pretty late. Sometimes it never happens at all. Other times, I’ve had residents who lose their ability to speak…English. What ends up happening, for many people who learned English as a second language, is that they’ll begin speaking their native language again. Even if they’d been speaking English for the last 50 years, their native language comes through. When this happens, I’ve found that the individual actually does understand English, but just responds in their first language. While friends and family may be confused as to what their loved one is saying, oftentimes the person living with dementia knows exactly what everyone else is saying to them. (Hence why you still don’t want to talk about the individual like they aren’t in the room!) Long-term memories are the ones that stick around. Knowing this, it makes sense why the language someone learned first would be the language that they retained the longest. If you have a loved one who is speaking another language, but you can’t understand it, don’t panic. You don’t need to download any translation apps or buy any books. Of course, it’s helpful if you understand a few words, but it’s not necessary. Here’s the thing: you can gather all the information you need by listening to body cues and facial expressions. It’s also important to note that I’ve had residents’ family members say to me, “I speak a little bit of Italian…and mom is just saying gibberish at this point.” Unlocking their verbal language isn’t going to unlock all the clues you need to assist your loved one. Just as many people living with dementia say nonsensical things in English, there’s a good chance they’re doing that again, just in their native language. Sign up to receive my blog emails here!

December 11, 2018

How Elvis saved the day

Photo credit: Public domain One group of people I particularly enjoy working with are people with aphasia. While it’s extra challenging—people with aphasia usually don’t speak—it can be really rewarding. When someone with aphasia does speak, you know that you’re really connecting with them. I had been with Kelly for five hours and she hadn’t uttered a word. Occasionally, she would smile, but that was about it. That was normal, and that’s what I expected. Still, I really wanted to get her to engage with me a little more than she was. I decided to try something that I knew we hadn’t tried before: music. Now, I didn’t know what type of music that Kelly liked, but I could take a good guess. I tried the classics: 1930s swing, big band, Sinatra, Johnny Cash, Glenn Miller. These artists got a smile out of her, so I knew I was on the right track. Then, I decided to look up some music from The King himself. I typed in “Hound Dog” on my iPhone and YouTube pulled up a video of Elvis performing the song live. Kelly’s eyes opened wider as the song began. I had placed my iPhone on the windowsill nearby, and Kelly’s eyes trained on the cellphone. She reached out a hand—which was normally shaking or picking at something on her lap—and stretched it out towards the window. I realized she wanted to hold the object making the music, so I handed her the phone. Kelly said something. I couldn’t hear exactly what it was, so I leaned in. She was telling me a story. It was quiet at first, and a little hard to follow, but I could tell that she was including me in a narrative about something. Suddenly, she started laughing. Like, really laughing. I started laughing, too, amazed that she seemed to engaged and lively now. “Do you like the music I’m playing?” I asked. “Yes, it’s so wonderful,” she smiled.

April 17, 2017

How to engage with someone who doesn’t respond

Belma’s eyes closed lightly as she was transferred from her bed into her wheelchair and brought down the hall for breakfast. She was peaceful, but did not seem to respond much to the world around her. At times her hands were restless as they sat in her lap: picking at the chair, a blanket, or something on the table in front of her. Belma had aphasia, which meant that she often did not speak. She did indeed “communicate,” as she would sometimes smile, nod, or touch a person who was speaking to her. Sometimes Belma would say a word or two, and it was almost always in context, which meant that she did generally understand what was happening around her. On this day, I wanted to try something new. Belma’s family did a good job of finding little things to occupy her time: greeting cards with interesting pictures on them, TV shows, music, soft blankets with zippers and buttons. Belma had never been one for animals in her younger years, but as her dementia progressed, she found great comfort in pets. [youtube https://www.youtube.com/watch?v=vU1hol5oo58?feature=oembed&enablejsapi=1&origin=https://safe.txmblr.com&wmode=opaque&w=540&h=304] I brought in the pet that Hasbro had sent me to try it out. My favorite pets to give to people with dementia are Memorable Pets, but I hadn’t had an opportunity to try out this animatronic cat that Hasbro had sent. The cat moved and meowed, responding to light and touch. For someone who could use another level of interaction, this cat was a good fit. Belma squinted at the cat, trying to understand what it was. She began to pet it, slowly at first, and a smile moved across her face. The cat meowed and Belma’s smile grew a little bigger.

April 12, 2017

Connecting with those who have aphasia

Aphasia is a disorder that causes someone to lose the ability to speak, or to have difficulty speaking. It is not uncommon for people with dementia have aphasia. One of my favorite things is when someone with aphasia speaks to me. It happens every once in a while. I’ve had a few residents with aphasia, although I have found that these are also often my most “expressive” residents. They mime, gesture, and sometimes move their mouths like they are speaking. Interestingly, I’ve found that even though these residents usually can’t speak, they make complete sense when words do come out of their mouths. I think a lot of people give up trying to talk to people with dementia who have aphasia. I make it a point to continue talking to them as if we’re having a two-sided conversation. You never know when that person is going to talk back. A couple days ago I was outside with Amanda. Amanda doesn’t speak, usually, but she’s very physically active: she loves walking up and down the hallways, cleaning, and picking up objects. Because she is so active and on-the-go, I decided to offer her a seat in a nearby rocking chair. She touched the wooden chair and said to me in a quiet voice, “I can’t sit there, it’s hot!” Joyfully I responded, “It’s not that bad, Amanda!” “No, touch it with your hand. It’s very warm,” she disagreed. I loved that her sentence made complete sense. It was almost as though she spoke every single day. Perhaps, in her mind, she was “talking” every day. Amanda seemed to shrug and went to sit in it anyway. As she settled in, she began to tap her feet on the ground, rocking the chair back and forth slowly. She closed her eyes, enjoyed the constant, slow movement, and went to sleep. – A post from a few months back

December 20, 2016

Talking Aphasia

One of my favorite things is when someone with dementia, who doesn’t normally speak, speaks to me. It happens every once in a while. I’ve had a few residents with aphasia, which means that they have (usually) the inability to communicate verbally. Interestingly, I’ve found that even though these residents usually can’t speak, they make complete sense when words to come out of their mouths. I think a lot of people give up trying to talk to people with dementia who have aphasia. I make it a point to continue talking to them as if we’re having a two-sided conversation. You never know when that person is going to talk back. A couple days ago I was outside with Amanda. Amanda doesn’t speak, usually, but she’s very physically active: she loves walking up and down the hallways, cleaning, and picking up objects. Because she is so active and on-the-go, I decided to offer her a seat in a nearby rocking chair. She touched the wooden chair and said to me in a quiet voice, “I can’t sit there, it’s hot!” Joyfully I responded, “It’s not that bad, Amanda!” “No, touch it with your hand. It’s very warm,” she disagreed. I loved that her sentence made complete sense. It was almost as though she spoke every single day. Perhaps, in her mind, she was “talking” every day. Amanda seemed to shrug and went to sit in it anyway. As she settled in, she began to tap her feet on the ground, rocking the chair back and forth slowly. She closed her eyes, enjoyed the constant, slow movement, and went to sleep.

July 17, 2016

A Conversation.

Elizabeth* usually cannot speak. Her dementia has impaired her ability to communicate verbally, but she’s incredibly expressive. Often, if spoken to, she’ll make noises like she’s talking, smile, and motion with her hands. Every once in a while, actual words come out, and it’s nothing short of magical. We “talk” constantly. I always talk to her, even though it’s a pretty one-sided conversation. She mumbles, nods, and sometimes says one word like, “yes” or “no.” I approached her at dinner the other day and smiled at her. Elizabeth was pushing her napkin around on the table. “Are you folding this?” I asked her, expecting, as usual, no real verbal response. “I was trying to,” she responded, quietly. I was stunned. The last time she had said a full sentence to me was four months ago. I was thrilled to hear her voice. Although she makes noises, I never get to hear what her voice actually sounds like. It was soft, rhythmic, and kind. The most interesting thing about this is that she responded completely in-context. Elizabeth knew what we were talking about. This makes me think that, even though she can’t usually use words, she is responding to me in context every time we “talk.“ "I’m glad that you’re talking to me! I like talking to you,” I said to her, trying to continue the conversation. “I do, too,” she smiled and nodded.

November 8, 2014

Sock Puppets.

I think there’s a lot that we can learn from people with dementia, especially those who don’t communicate in normal ways. I’ve blogged about a few of my residents with aphasia before, but there’s one in particular that always keeps me laughing. Truly, I’m laughing with her, because she’s always “telling” jokes. She has aphasia, which means that she typically has difficulty communicating verbally. Instead, she mouths words, dances, laughs, mimes, and points. I wish that my readers had the chance to meet this woman. When we play balloon toss, she grabs the balloon out of the air, wipes her brow with exaggerated exhaustion, and plops down in her chair. She cradles the balloon in her arms and sticks her tongue out, smiling, suggesting that she’s so tired from the hard work. She lays her head down on the balloon and pretends to sleep. The other residents laugh with joy, because they too love her expressions and miming. A couple of days ago we were folding socks. This seems like a silly activity, but to many of my residents, it’s a great reminder of a life skill they used to do. This particular resident picked up a sock and slid it over her hand. “Mmm, hmm, hmm!” she said, moving the sock around like a puppet. She made silly faces, smiled, and did a little dance with her new puppet. It’s magical to watch this woman communicate with love, intelligence, and hilarity. She can’t speak, but she truly seems to enjoy each moment of each day.

June 15, 2014

Shh, he's sleeping.

We have a couple residents who don’t speak much, if at all. We also have a “baby station” that is set up to look like part of a nursery. A couple of us worked to relocate the station to an area where more residents would interact with it, and we have had a lot of success. A couple of our residents really love holding and dressing the realistic-looking baby. While most of the residents just ignore the baby station or think “it’s so cute!” others are in the stage where they believe the baby is real. I gave a tour of Clare Bridge once to a man who said, “What a sad disease” when he saw the baby station. After working in this field for so long, I was taken aback. The baby station to me was a happy symbol— a happy way for people to express love and bring back memories. I think he felt like it wasn’t fair that dementia takes people to a place where they believe a toy baby is real. But if that’s where a person is happiest, isn’t it great to give them the opportunity to play with a baby? Last night a coworker walked in to find one resident holding the baby in a blanket. The resident is primarily nonverbal, and doesn’t express much through body language. She sat, comforting the baby doll, pulling the blanket up around its body. “What have you got there?” my coworker asked. “Shh, he’s sleeping,” the resident responded. “I heard him crying.”

May 24, 2014

Aphasia.

One of my favorite residents has aphasia, which essentially means she can’t communicate verbally. I also refer to this as “nonverbal,” because she does try to communicate how she’s feeling through body language. She loves to dance, smile, and sometimes uses simple words like “yes” or “no”. She’s very pleasant and is almost always smiling silently, so I try hard to engage her in activities. Today we went to a restaurant and I sat next to her. She looked at her menu for a while and then offered it to me. “Do you want this?” she asked.

May 16, 2014