A characteristic symptom of Alzheimer's disease is problems associated with memory-related communications. Typically, Alzheimer's people will experience an inability or difficulty, find the right words to express themselves to others. On the other hand, some individuals have trouble understanding what people are saying to them, or immediately forget what they've just heard.

When people with Alzheimer's have trouble finding the right words to communicate their thoughts, they may describe an item they cannot name, or substitute words that have a similar sound or meaning. It takes much patience to communicate with individuals who forget names, struggle for the words they want to use, never finish a sentence, or repeat the same phrase over and over--all problems that may be experienced by people with Alzheimer's disease. To facilitate communication, try these strategies:

* Relax. People with Alzheimer's communicate better when they do not feel pressured.

* Keep distractions to a minimum. Turn off the radio and television. If others are in the room, find a quiet spot.

* When the person has trouble expressing a thought, guess what may be meant by asking questions they can answer with a yes or no. For example, " Do you mean...?" or "Do you want to go...."?

* Sometimes people forget what they are saying and stop in the middle of a sentence. To help them start again, calmly repeat the last few words they said. If they can't continue, ask a question that relates to what they had been saying.

* Make sure you understand what they have said. Questions like, " You want to leave now, is that right?" or " You want some milk, don't you"? will verify what's been said.

* You may have to decipher a meaning from a few words. The person's tone of voice and body language may also help you figure out what they mean. For example, a shaky voice and fidgeting behavior may convey fear more than their words can. Many people have limited access to the words they want to use. "Walk now" may mean a person is uncomfortable and wants to leave the room.

People with memory loss may understand what you tell them but then quickly forget what they understood. You can help keep the communication lines open between you and the individuals with Alzheimer's by using such reinforcements as the following below:

* If the person wears a hearing aid or glasses, be sure they are the correct prescription and are working properly.

* Keep background noise and other distractions to a minimum.

*To get the person's attention and help maintain his or her concentration, frequently address the person by name, maintain eye contact, and gently touch his or her hand or arm. *

Speak clearly and slowly, using simple words and phrases. " Bill, please give me the book" is more likely to be understood than " Bill I want you to pick up that book and hand it to me".

* Be specific about things, places, and activities. Say " Let's go to the store" rather than " Let's go out"; " Do you want an apple?" rather than " Do want some fruit?"

* When you need to repeat a statement or question, use the same words each time. If " Betty, please give me the pillow " does not prompt Betty to get the pillow, repeat the request exactly the same way. " Toss the pillow over here" will only confuse the person.

* Use flash cards. Simple drawings or photographs pasted on cardboard can help you communicate, especially with individuals who have lost most or all of their verbal skills. Use pictures of a toilet, bathtub, lamp, items of clothing, pillow, blanket, bed, toothbrush, glasses, and food items.

* Act out an activity you want preformed. Actions like eating, drinking, walking, lying down, and combing hair are easy to show.

Using such strategies becomes an integral part of day-to-day living and caring for a person with Alzheimer's disease. It can be a frustrating and disheartening experience for the caregiver, especially when the person is a loved one whose capabilities were relied upon and respected. Nevertheless for many people the reward of maintaining contact and possibly slowing the course of the disease are well worth the effort.

(c) copyright 1994