The Whitworths of Arizona, bringing science to you in everyday language.

Friday, February 28, 2014

LBD and Communication 2: Problems Not Related To Language

A couple of weeks ago, the blog was about language-related problems for the Lewy partner (the person with a Lewy body disorder). Communication is a huge issue for the Lewy partner. Without good verbal skills, they often find it difficult to be understood. This week is about some of the Lewy-related problems with communication that aren’t directly connected to language.

Thinking errors. Lewy causes a variety of thinking errors. Some result in delusions as described previous blogs. Others are less obvious.

I had to be careful how I told Quentin to do something. He’d go when I said, “Don’t go…” or sit when I said, “Don’t sit.” I guess he didn’t hear the negatives. –Beth

The subconscious brain, even when healthy, tends to ignore the negative prefix to a directive—hypnotists learn that “sit” and “don’t sit” often generate the same sitting response. It is the thinking part of our brain that recognizes the negative prefix. Quentin’s weakened ability to discriminate caused him to ignore the negative parts of Beth’s directives and do the opposite of what she wanted him to do.

Muscle rigidity. Quentin may actually hear what Beth wants but his body isn't complying.

Sometimes I'll tell Quentin to lean forward and stand up. Instead he pushes back and appears to resist me.   --Beth 
Lewy bodies can cause muscles to become rigid, so that when requested to do something, a Lewy partner appears to be resisting. This is unconscious. In fact, the more the person tries to follow directions, the more rigid the muscles will get. This is also temporary, so that once the pressure is off, Quentin may do the same thing easily, as though he had simply been being difficult or contrary.

Slow thought processing. As Lewy advances, thinking gets bogged down more and more. The Lewy partner processes everything very slowly—for others, that is. For them, their mind is racing a mile a minute trying to wade through everything that’s going on. It’s like your car when it is in mud and the motor is racing but you are hardly moving.

One evening, before we knew there was anything wrong with Bill, we took my dad out to dinner. I asked Bill if I could have his butter if he didn’t want it. He ignored me, and just sat there looking at his plate. I’m easygoing and so I didn’t push; I just went on eating and visiting with my dad. Five minutes later, Bill picked up his butter and put it on my plate. Years later, after his diagnosis, I remembered that and understood that he’d been processing my question that whole time. –Marla

Marla asked a compound question; one with more than a single idea to be processed: a) Did he want it and b) Could she have it. Such questions take more time to process because each component must be considered individually. Also, Marla’s conversation with her father may have been distracting, making processing the request harder. Bill would likely have had to start over if Marla had repeated her request or asked if he had heard her.

Attention deficit. A Lewy partner gradually gets to where they cannot focus on more than one two things at a time.

I get agitated when someone tries to talk to me when there is loud music in the background. I am also beginning to notice that I hate it when there’s more than one person with me in a conversation. And don’t go talking about too many things at once. –Joel

Joel’s brain can handle only a limited amount of input at any one time. It works hard to process that. Any more just doesn’t compute.

Light sensitivity. Lewy partners aren’t just sensitive to drugs. They are often also sensitive to light. They may frown or squint. They may also simply close their eyes and appear to be bored or asleep.

LBD is not necessarily the only thing causing communication problems. If you suspect that the Lewy partner has any of these or some other similar problem, have them checked.

Poor hearing can decrease and/or distort the sound of voices, making them difficult to understand. Even a healthy person can become isolated by deafness.

Poor vision can hide and/or distort visual information. Add LBD’s visual problems such as hallucinations and partial blindness can be very distracting.

Depression and apathy may make the effort to communicate seem too much to deal with.

Pain, infections and other illnesses will take priority and remove focus away from communication. They also add stress which increases any LBD symptoms already present.
Next week, the blog will discuss the non-verbal ways that a Lewy partner communicates. And the week after that, we will finally get down to how to use this knowledge to communicate better with our loved ones. Better communication goes a long ways towards decreasing stress and the accompanying Lewy symptoms.

Find more about LBD in The Caregiver's Guide to Lewy Body Dementia available on in the LBD Book Corner.

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