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Caregiver’s Corner: Visiting Your Loved One’s Country—Navigating Dementia Without Words

Communication is almost always difficult under even the best circumstances. Communication with someone who has dementia can feel impossible at times! What can we do when the fabric of communication, language, is unravelling?

When you can’t control the circumstances that make communication difficult—such as dementia—you can still adopt a mindset that makes understanding easier! I want to carry on the theme of today’s video by talking a little bit more about how assuming the role of “visitor” or guest can help you manage communication with someone who has dementia.

What’s that? You skipped the video? OK, go back and watch it and we’ll pick this back up… 😃 📽️ 

If you’ve ever been a guest in a foreign country, especially one where you don’t speak the language, you’ve probably thought about how best to observe the etiquette of a different culture. This can be difficult when you don’t even know how to ask what you did wrong!

I’d like to use this metaphor of visiting a foreign land to tease out the idea of how we can interact beyond words when we help someone with dementia. To do that, I want to tell you about an actual trip that I took, and a wonderful experience I had, that would have been lost to me if it required verbal communication.

In 2013, I was on a business trip to China and had an experience that transcended spoken language. One day, when my group was on our way into the office, we had stopped at Starbucks—where else?—and through the window we saw two people practicing Tai Chi on the sidewalk.

If you’ve been a long-time reader of this newsletter, you’ve probably heard me mention that one of my lifelong passions is martial arts. Here was a gentleman in traditional Chinese dress teaching a business man in a suit and tie. They were standing in the middle of a bustling crowd, getting in a few minutes of instruction before Mr. Executive got to the office.

I was impressed—the teacher was really good—and I was telling my co-workers about the body mechanics they were using. The teacher must have seen a gesture I made, because he looked right at me and waved me out to join them. Gulp.

I waved a “that’s all right” gesture, but he beckoned again. Refusing twice would have been verging on rude, so I walked outside, bowed, and took instruction for two or three minutes. Mr. Executive could translate a little, but it was really all about touch.

Once our hands and arms came into contact, we didn’t need to talk. I received their gentle force and they received mine. We felt for each other’s centers of gravity and the small currents of force travelling through the body. We both understood the other perfectly, and no words were necessary.

I stayed as long as seemed appropriate, just a couple minutes. Then I bowed with big smiles, and they bowed back, and we went our separate ways. Even 12 years later, I think fondly about that moment and smile at the unspoken etiquette and love of the art that transcends thousands of miles and all language. I wish I could have a few more minutes with him today to see how we’ve both grown in the intervening years.

So let’s look at some of the things I did in an effort to communicate across a cultural and linguistic divide. As we talk about this, start considering how these points might relate to your communication with a person who has dementia.

1. I was respectful of the people and did not want to intrude or overstep.

2. I refused, then accepted. In the martial arts world, and eastern cultures in general, to refuse an offer once is good manners. To refuse a gift twice is ok, but slightly awkward. To refuse three times can be seen as impolite. I refused once in order to be polite, and then I accepted, also in order to be polite (and I really wanted to!).

3. I used body language that deferred to the teacher, from bowing first (and lower) to assuming what I can only call a “learning posture”: interested and curious.

4. I tried to absorb their drill with my whole effort. I didn’t try to do my own thing or show them something. I was a guest, and as such I wanted to accept their gifts with grace, and honor what they had offered me by giving my full attention and effort.

5. I left when it was time, making my bows and showing my gratitude. We did the thing where it seemed like the last person to bow would win a great prize! I think I was still bowing walking backward half-way down the street. I was not to be outdone on my humility! 😊 🙇‍♂️ 

So how does all of this relate to talking to someone with dementia? Let’s start with the respect concept. On a deep level, I think we generally respect our loved ones. However, there’s also that old phrase: familiarity breeds contempt.

There aren’t many things more “familiar” than helping someone with bathing or toileting. As we become used to the tasks, we may even start to distance our minds from them while we perform them because they are frankly unpleasant or just mechanical.

When we distance ourselves from the task, we have a tendency to distance ourselves from the person. If we have removed ourselves from our loved one’s experience, how can we be respectful of that experience? Even when you can’t communicate with words, respect can still come through when you are fully present.

Next, show that you can follow the rules! You probably know your loved one’s “rules” better than anyone else. What is the etiquette in the family? What agitates your loved one? What’s their favorite music? TV show? Meal? What are the unspoken agreements that make up that dynamic? When are they happiest? Following their rules and meeting their needs in a way that they like is one of the best ways to establish respect.

Now, what does your body language say? Are you leaning in and interested, even when you don’t know what they’re talking about? Are you validating their experiences by mirroring their body language or adopting calming body language? When your loved one looks at you, do they clearly see that they have your attention?

Are you focusing your attention completely? Like, “first date” levels of focus? When you engage completely, the other person will feel validated. I know I feel important when someone else silences their cell phone and sits down with their full attention on me. Do we do that for our loved ones, or do we view caregiving as “wasted” time if we aren’t multi-tasking? People with dementia want to feel important too.

Finally, do we bring it back to gratitude? Can we take those moments of care and find something to be thankful for? Since I’ve started looking for those moments, I’ve felt a subtle joy infuse my time with my mom that I hadn’t felt before. Genuine gratitude has come into those times together.

I know this is all “in a perfect world” advice. That said, if you can occasionally take up this attitude of being your loved one’s guest in a world that exists deeper than the spoken word, you have a chance of having a deeper experience with them.

12 years after that experience in China, I still remember it vividly. 12 years from now, I hope my memories of my time “visiting” my mom are just as vivid. They will be, if I enter our interactions with respect, giving my full attention, and listening beneath the words to hear the whispers of her spirit.

📰 Non-Verbal Communication Resources 📰

Here are some additional resources on non-verbal communication:

• The Importance of Body Language in Dementia (Psychology Today)

• Non-verbal communication and dementia (Alzheimer’s Society)

• How to Talk to Someone with Dementia: 5 Communication Tips (Sunrise Senior Living): commentary