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

Friday, March 7, 2014

LBD and Communication 3: Methods of Communication

Past blogs have discussed the many communication difficulties a Lewy partner (the person with a Lewy body disorder) faces. As verbal communication becomes less effective, other types of communication take over. We sometimes forget that we use a variety of ways to get our messages across. Most of us think of communication as being mostly verbal. However, as the ability to communicate verbally decreases, other methods become more important.

A few weeks ago Kevin started yelling and trying to fight me. I couldn’t understand why he was so angry. He’s usually so mild-mannered and sweet. I didn’t know what to do, but I remembered that stress can mess with communication. I thought that if Kevin was this angry, then something very serious was going on with him. I thought it might be delusions. I’d heard a lot about how they can make a person act out. But he wasn’t making accusations. It was more like he was trying to fight me off. –Sarah

Although the message may be garbled and inaccurate, something was likely stressing Kevin. Some of his intensity might have come from the frustration that he wasn’t able to communicate well enough for Sarah to understand him. However, Kevin could also be just as angry over a small irritant as over a very painful one.

Kevin has a history of ulcers and so I asked him if his stomach hurt. He became very excited and tried to hit me. I almost called 911. This was getting dangerous. Then I remembered reading that sometimes touch will work when words won’t. And so I gently touched his stomach and asked him if it hurt there. He collapsed into a chair and nodded. I gave him some mild pain medication and he quieted down. In fact, he went to sleep. I called the doctor and got an emergency appointment for the same day. Kevin is now on medication for ulcers. –Sarah

Intensity, words, touch, tone of voice, body language and facial expressions all convey messages. Recognizing Kevin’s angry behavior as communication, Sarah tried to understand what his behavior meant. Before resorting to a medical solution, she thought it through and checked her conclusions by using touch instead of words.

Intensity. This reflects the amount of tension involved. The mode of communication may change but the intensity of the message may remain. It affects expressions, actions and voice tone. A low softly voiced “I love you” accompanied by a gentle touch and a loud “I love you” accompanied by a frown have totally different meanings. As a general rule, the louder, more energetic or negative an interaction, the more stress it suggests.

Intensity is not a constant for the Lewy partner. Without an ability to judge the severity, a Lewy partner either hurts or he doesn’t. He is either scared or he isn’t He is either angry or he isn’t. Although he will usually respond better to a low intensity communication, he may not be able to adjust his own intensity appropriately.

Verbal communication. Lewy symptoms impair verbal skills more than any other type of communication. Words are symbols we use to express our feelings and thoughts. We hear words and use our past knowledge to interpret what they mean. We respond internally with a feeling or thought, interpret that feeling into words, and reply.

When LBD damages a person’s thinking abilities, the interpretation steps often get missed or garbled. Words become either misunderstood or unavailable. Then when muscle problems make talking harder to do and understand, many Lewy partners choose to talk very little.

Next week’s blog will be about communicating via the senses.

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

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