Consultant’s Corner – October 2019

Consultant’s Corner – October 2019 post page

Carolyn Lukert

By Carolyn LukertOctober 24th, 2019

Consultant’s Corner – October 2019


by Carolyn Lukert, MBA, CGCM,
PAC Consultant and Mentor

Dear PAC Consultant,

I take care of my mom. She has not officially been diagnosed with a specific type of dementia, but her doctor has done the initial assessments and says it is one of those diseases that falls under the umbrella, as you call it.

I am wondering if you can help me with a communication problem we are having. It seems like my mom just isn’t getting it much of the time. I actually thought she had a hearing problem because of the number of times she says what?” when I speak to her. I took her to an audiologist and, it turns out, her hearing is just fine. In fact, she can often hear things that I can’t. She actually startles when even the tiniest sounds are made. Yet, she still doesn’t seem to understand me.

                                                                                                       I am … Stumped in Seattle

Dear Stumped in Seattle,

Now that is puzzling, isn’t it?  It seems as though your mom is able to hear (the sound is making it in), but she is not able to understand.  Here’s the thing, sensory processing changes for many people living with dementia. Why? Because the brain controls everything and, with a true dementia, at least two parts of the brain are dying. For most people, the part of the brain that is responsible for comprehension (understanding what is being said) is the left temporal lobe. And, that part of the brain is impacted early on with many of the dementia-related diseases. As a result, individuals living with dementia may actually drop every fourth or fifth word as sound goes in at a normal rate of speech. While I know that doesn’t sound like much, try deciphering this:

Unless someone like cares a whole awful nothing is going to it’s not.

So, I wonder how you might get curious about your mom’s sensory changes. Next time your mom says "what?" notice what you said, where you said it in relation to her, and how quickly you said it. Could it be that you: used a lot of words? spoke quickly? or you were not where she could see you?  Along those lines, perhaps try shortening and simplifying sentences, and slowing down – not so much that it resembles childlike talk, but enough that your mom has chance to absorb, think, and respond. Also, I am wondering if using more visual cues to replace words might help. So, for example, instead of saying – "Hey mom, would you like some coffee?" How about "Hey mom (hold up a coffee cup and point to it), coffee?"

Just so I don’t leave you hanging, here is the phrase above with just three missing words added back in:

Unless someone like YOU cares a whole awful LOT, nothing is going to get BETTER, it’s not.

                                                                                                                 Dr. Seuss, The Lorax

Just a few missing words can make quite the difference!  Do you understand?

                                                                                                                                   All the best,

                                                                                                                            PAC Consultant

4 Comments on “Consultant’s Corner – October 2019”

  1. Avatar

    Hi. Very helpful article, thank you. You mention that at least two parts of the brain are affected/dieing in a true dementia; the one discussed here is left temporal lobe. What is the other? thanks. Jani

    1. Carolyn Lukert

      Thanks for your comment, Jani, and great question. The parts of the brain that are affected, and the order in which they are affected, really depend on the specific disease causing the dementia-related condition. For example, with Alzheimers Disease, the hippocampus and left temporal lobe are impacted early in the disease (for most people). Other parts of the brain are impacted later in the disease. Vascular dementia may have a very different starting point and progression depending on where blood flow to the brain was compromised. So, starting points, and progression vary disease to disease, and person to person. Makes it pretty complicated, doesn’t it?

  2. Avatar

    I was wondering why mom seemed to not hear well, even with her hearing aids in. I have noticed if I slow down when talking without changing my volume, she does hear me then. This answer was very helpful and I will share with my family.

    1. Carolyn Lukert

      Thanks for your comment, Helen. It’s just so interesting, isn’t it? This idea that changes in hearing aren’t always the type that can be corrected by hearing aids, but can be supported by changes that we, as care partners, can make. I am glad you will share with others! Take care!

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