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Challenges of Communication

The television is blaring. You went to all the trouble to get off work a little early so you could stop by and see your father, and now he won't even turn down the TV. He stares at the screen and ignores your attempts at conversation or answers you with a curt "Uh-huh" or "Huh-uh." Finally, to your amazement and confusion, he gives you a disgusted look, gets up, and storms out of the room.

What's going on here? Communication has broken down, and you need to figure out why.

First, consider that your dad might have a hearing problem. Hearing is a complex function that involves a number of abilities. The mechanics of the ear have to work correctly, or Dad's not going to catch all that you're saying.

Then his brain has to be able to understand and interpret your words. This is known as receptive language.

He also needs to be able to use expressive language: he has to be able to call up the words he needs to use when he needs to use them.

Finally, the mechanics that enable speech must be working properly for him to speak those words in an intelligible manner.

There may be breakdowns at any point here, and they can be brought about by any number of events. Sometimes it's very clear after a person has had a stroke that her ability to converse has been severely impaired. However, a gradual loss of hearing may go unnoticed.

Then, too, the mechanics may be working fine but there is -- or always has been -- a problem when it comes to the two of you talking with each other. Why? Perhaps a basic personality clash. Perhaps a history of miscommunication or misunderstanding that goes back decades.

In any case, as you well know, communication is a critical skill for all caregivers. Your goal is to express an idea clearly with understandable words while, at the same time, saying it with compassion and respect.

These are suggestions to make communication with your parent easier:

--Be sure to face Dad when you're talking to him. Speak slowly. It may take him a little longer to come up with the right word. Don't jump in and finish his sentences for him.

--Identify the problem. Begin by asking questions with only yes or no answers. Then ask questions that can't be answered with yes or no. Take note of how your parent responds. This will give you a better idea of your parent's cognitive abilities.

--Don't try to communicate when you're angry.

--Don't get distracted with unimportant details. Keep communication simple.

--Plan what you will say. Not just the concept, but the words, too. This will help you hear what your parent is going to hear.

--Remember that if the time comes when verbal communication is no longer possible, touch can be a form of communication.

--If your parent has a form of dementia, learn from the experts. Research the field for help in communicating with a person who has dementia. For example, if you make a statement and don't get a response, it might be best to repeat the statement exactly instead of paraphrasing it. Your parent may be taking time to process a response, and a paraphrase will seem like a whole new thought.

--Try to be patient. Remember that even in a world of cell phones, microwave meals, instant replays, and the Internet, some things still can't be rushed. Conversing with your parent can give you a much needed opportunity to slow down, take a deep breath, and remember, once again, what's really important in life.