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Communication Challenges

Communication with a mentally or physically impaired person can be a difficult and frustrating task, but good communication skills can prevent catastrophic reactions. In dealing with persons with limited physical or mental abilities, it is important to listen, speak clearly and slowly and use non-verbal communication (body language) to help convey your message.

Communicating with aphasics

Aphasia is a total or partial loss of the power to use or understand words. It is often the result of a stroke or other brain damage. Expressive aphasics are able to understand what you say; receptive aphasics are not. Some victims may have a bit of both kinds of the impediment. For expressive aphasics, trying to speak is like having a word “on the tip of your tongue” and not being able to call it forth. Some suggestions for communicating with individuals who have aphasia are provided below.

  1. Be patient and allow plenty of time to communicate with a person with aphasia.
  2. Be honest with the individual. Let him/her know if you can’t quite understand what he/she is telling you.
  3. Ask the person how best to communicate. What techniques or devices can be used to aid communication?
  4. Allow the aphasic to try to complete his/her thoughts and to struggle with words. Avoid being too quick to guess what the person is trying to express.
  5. Encourage the person to write the word he/she is trying to express and read it aloud.
  6. Use gestures or pointing to objects if helpful in supplying words or adding meaning.
  7. A pictogram grid is sometimes used. These are useful to “fill in” answers to requests such as “I need” or “I want.” The person merely points to the appropriate picture.
  8. Use touch to aid in concentration, to establish another avenue of communication and to offer reassurance and encouragement.

Communicating with persons with Alzheimer’s Disease or related disorders

  1. Always approach the person from the front or within his/her line of vision with no surprise appearances.
  2. Speak in a normal tone of voice and greet the person as you would anyone else.
  3. Face the person as you talk to him/her.
  4. Minimize hand movements when near the other person.
  5. Avoid a setting with a lot of sensory stimulation such as a large room where many people may be sitting or talking, a high-traffic area or a noisy place.
  6. Maintain eye contact and smile. A frown will convey negative feelings to a person.
  7. Be respectful of the person’s personal space and observant of his/her reaction as you move closer. Maintain a distance of 1.5′ initially.
  8. If a person paces, walk with him/her, in step with him/her while you talk.
  9. Use distraction if a situation looks like it may get out of hand. Examples: if the person is about to hit someone or if he/she is trying to leave the home or facility.
  10. Use a slow, low-pitched speaking voice – the most audible to older adults.
  11. Ask only one question at a time since more than one question will increase confusion.
  12. Repeat key words if the person does not understand the first time around; nod and smile only if what the person said is understood.