How Dementia Affects Conversation and Relationship

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Dementia can create differences in the way we connect with others.

1 Corinthians 13:7 “(Love) always protects, always trusts, always hopes, always perseveres.”

Self and Others: Recognizing Dementia

Many of our residents, especially those in our higher functioning houses, have a sense of not fitting in with their housemates. They look around and interact with their housemates and they recognize the dementia in others. This may be clear recognition or simple noting of others acting strangely, or some combination of these two things.

However, when these same individuals think of themselves, they may or may not recognize their own dementia. Those that do, may not accurately gauge the extent that their cognition and memory is impaired. It seems that most don’t remember that they have dementia at all. Many times, residents think of themselves as much younger than their housemates, even if they are not. A 10-15-year age difference may be perceived as much greater, and so they do not see their housemates as peers. Those that hear, see and speak well, especially, seem to fall into the category of people who see themselves as completely unique from their group of memory care residents.

Dementia and Connecting with Compassion

I remember a conversation with a woman that I’ll call Sally. Sally was upset with one of her housemates.  That housemate had done or said something minor, but it was bothering Sally. Just an action that this other person would not have done, if they did not have dementia. When the person causing Sally to be upset was not within earshot, I explained to Sally that this person has some cognitive issues and that is why they were behaving unusually. Sally quickly mellowed and showed some empathy. She then said to me that it’s too bad this person has dementia and then said, “I hope I never get like that.”

I’m not quite sure where Sally thinks she lives or why, but she clearly feels comfortable and ‘at home’ as a resident. She recognizes others’ behavior as unusual at times, but she does not recognize the very clear reality that this other person has dementia. If she did, she would likely show compassion more regularly in her interactions with her housemates. 

Varying Perceptions, Similar Struggles

In talking with other residents, and especially families of our residents, I’ve learned that many others in memory care express these same feelings: stating they have few friends among residents, or that they are lacking opportunities for companionship. Some residents continue to think of themselves as completely dissimilar, when in fact they are much more similar than they recognize.

Many of our residents who think of themselves as not fitting in are people who see, hear, and speak well. They notice others and what is going on around them in the moment. Often, they can have a conversation with people who do not have dementia, especially friends, family, and staff. They enjoy conversation with those closest to them, but many of these same people struggle to talk with housemates. No one is there to guide the conversation, fill in blanks, and know shared topics of interest. It’s also sometimes true that residents are better talkers than listeners. Following another person’s stories can be too difficult. They struggle to respond or initiate conversation. 

Connecting When Senses are Diminished

Those that can’t hear as well or see as well seem to notice others behavior less and have more difficulty interacting with others due to these deficits. It seems they do not notice others’ behavior as much due to their diminished senses. They may chalk up their lack of interaction with housemates as more a symptom of diminished senses rather than cognitive diminishment.

I know a man who prior to dementia, was extremely engaging. He was a thoughtful and active listener and loved hearing other’s life stories. A couple of times, I have tried to get him to talk with another resident who has stories to enjoy. Even as I’ve tried to facilitate these conversations, this man continues to tell me he has no interest. He is not rude or callous, he simply states he has too many other things to think about no, and little time. 

Still, he loves to tell his own stories. If he has known someone for years, he will still listen and engage others to an extent and have a two-way conversation. But to those he has not known long, he can only tell his stories or talk about day to day things such as meals or the weather. He can’t engage others to any significant extent about their lives, and he thinks of himself as unique from the others. He has little empathy for his housemates, and so he does not engage them. 

Relationships as Dementia Progresses

There is another man in the same house who is very similar to him who would love to strike up a friendship. Neither man can seem to initiate anything with the other on their own. Both men, prior to dementia, would have very easily and happily engaged the other. It is a frustrating reality to these men’s families: both men would seem to greatly benefit from a friendship with the other. Their families would greatly benefit from knowing that their loved one has a friend. However, each man participates increasingly less in the activities at the house, again because they believe those activities are geared toward people unlike themselves.

As dementia progresses, it seems many individuals who don’t think they fit in can become more social.  They don’t recognize unusual behavior or repetition due to their increased dementia. Two ladies I know can hear, see, and speak well and they have long conversations together, but these are often just the same short conversation over and over again, neither of the two realizing the repetition. These ladies don’t recognize that they have dementia, but they recognize that they are quirky and happily embrace it. These ladies truly enjoy each other’s company.

 A sad reality for many seems to be that greater happiness in life is realized once dementia becomes more profound. They are in a state of recognizing others as either having dementia or having atypical behaviors but not recognizing their own. Understandably for families, when the dementia increases and so does overall contentment, the progression of dementia is both a blessing and a sad loss of part of the person that they love.

Blessings to you all on your lives’ twists and turns, joys and sorrows.

Reverend Arlen Solem

Chaplain and Campus Pastor

For questions about our spiritual care program, or if you would like spiritual care and support for you or your loved one, contact Chaplain Arlen Solem at 612-554-6379 or apsolem@augustanacare.org.

At Emerald Crest, we offer a deep knowledge of memory care in a specialized assisted living setting for seniors with Alzheimer’s and dementia-related conditions. We encourage you to contact us directly with any questions or request a tour.

Emerald Crest provides memory care in a unique environment, specifically designed to support those with cognitive issues. Utilizing this exceptional model of care, individuals with dementia, Alzheimer’s and related conditions can flourish in positive relationships and participation in meaningful activities. Memory care is offered in the Minneapolis – Saint Paul area with communities in four convenient locations: Shakopee, Burnsville, Minnetonka and Victoria, MN.