March 8, 2021 Communication

We all communicate in different ways….words, writing, body language, facial expressions or maybe by our silence.  In the past, Lisa’s strength has been her written communication. When her speech was difficult to understand, we could ask her to write it and could often tell what she wanted from her writing.  Even before her stroke, she was losing her ability to write and can barely write her name anymore. She does however continue to read even though I’m not sure of her comprehension.  I help her to open the cards and gifts that you send her because it’s hard to open things with one hand but she always grabs the card and reads it.  At every meal, they give her a menu card where she makes her choices and she loves to read what’s on the menu.   Arden has said that he thinks sometimes I know Lisa better than Lisa knows Lisa.    When she says “pop”, I know that she wants a Diet Coke.  She doesn’t say “may I have a Diet Coke?” Or “Can you get me a Diet Coke?”, she simply says pop or soda or coke and I know that’s what she wants.  Lately she has had some frustration and is having a hard time telling staff what she wants.  She indicates that she wants to lie down and 10 minutes later she wants to get up,  She wants her blanket on and then she wants her blanket off.  She’s not sleeping as much and she’s restless, possibly bored. She doesn’t know how to use a call light so she hollers for staff which can be upsetting to other residents.  It is hard for staff to understand what she wants and I am having trouble understanding her also.  Sometimes she says that she is having a hard day and cries.      Sometimes her words come out as a word salad………which refers to  random words or phrases linked together in an often unintelligible manner. Often, we are unable to understand the meaning or purpose of the phrase. She said “van” to me this last week after we had taken a van to her appointment and I asked her if she wanted to go for another van ride and she said yes.  Another time she said a phrase “different arrangements” that came out of nowhere and I had no clue what she wanted.  Many times she simply cannot find the right word to say.  Her cousin Ashley visited this weekend and although Lisa couldn’t say who she was, hours later when I visited her she said “How’s Ashley?”   Echolalia is another thing that she does.  It is the unsolicited echoing of what another person says.  For instance I will be talking about Kirsten and Joey’s dog, Bailey whom she loves and she will repeat “Bailey”.  So if staff ask her “are you upset?” And she repeats “I am upset” is she really or is she just repeating something that she heard? Especially because being upset is not  a term she’s used much in the past.  Today, she wanted to go outside so we did and she said “car” and I said I walked so my car wasn’t there. I asked her if she wanted to go for a ride and she said yes. I said she has to walk or at least stand before she can go in the car. So we visited the therapy department and they said I could encourage her to lift her weak leg as often as possible. We went back to her room and after she lifted her leg three times she looked at me with a grin and said “car”? When I said that I couldn’t get her into the car she said “father”. So communicating can be a big puzzle right now which is not unusual for people who’ve had a stroke or for people with dementia.  We are going to try a communication board which has pictures of common things so she can tell us if she is hungry or thirsty or lonely etc.  I am hopeful that this will work especially because we think she can still read. Communication is so important and we can’t read other peoples minds…we can only guess at what they are trying to say and ask more questions.