A while back I had a conversation with someone who has dementia. I’ll call him James. The conversation went like this:
James: You made it back from the city, I see! (He’s very enthusiastic about this, and I have no idea what city he is referring to. However, I am happy he’s so glad to see me.)
Elaine: Yes! I always make it back!
James: Well, if it’s not one thing, it’s another.
Elaine: Ain’t that the truth? Such is life. (We both laugh knowingly and shake our heads.)
James: And you sure did a good job with that dog! (Although I have three dogs, James doesn’t know this, and I have no idea what dog he is referring to. I don’t ask.)
Elaine: Oh, that dog can be such a little brat! (We both laugh.)
James: I see how it is. I don’t know what Mom was thinking.
Elaine: Oh, I sure don’t either, James. (And we laugh some more, as I shake his hand and move on.)
A short conversation that would make no sense to anyone who may have heard it, but a really, really good connection that somehow makes my day. It’s about the connection, not the content.
There is a natural rhythm of conversation, and it usually perseveres in those who have dementia after the content doesn’t add up.
Sometimes those with dementia have a go-to line that they use to try to mask their lack of understanding of the world around them. For my husband’s grandpa, it was “You never can tell.” And sometimes it’d make sense.
We’d ask, “Do you think it’s gonna rain?” He’d say, “You never can tell.” We’d ask, “Are the Hawkeyes gonna win on Saturday?” He’d say, “You never can tell.”
However, as the disease progressed, he’d use his go-to line more and more, and it made sense less and less. We’d ask, “What’d you have for breakfast?” He’d say, “You never can tell.” We’d ask, “How do you feel about all this snow?” He’d say, “You never can tell.”
But, still, the rhythm of conversation was there. He knew from the rhythm of someone’s voice when he was asked a question, and he knew when a response was required. If you were doing something else and listening to us talk in the background, you might not notice his responses didn’t make sense.
For some people with dementia, responses become what could be considered jibberish. A few weeks ago, I asked a woman how she was, and she responded with a very enthusiastic, “Dippity doooooo!” She knew I was asking a question, even if she didn’t quite understand the question, and she knew my question required a response, even if she no longer had a way to find those words. When I said I was glad she was having a good day, she responded with a crisp, “Boop!” It was a positive interaction.
I can have a ten minute talk with someone who has dementia, be completely unable to identify what we talked about, and feel like it was a pretty great conversation. Sometimes these conversations are the best conversations I will have all day. But it’s not always that easy.
Sometimes people really want to tell me something but can’t find the words. Imagine how terrifying that could be. You have something you want to express but you cannot find the words because your brain is dying. And then sometimes people just shut down. They stop talking altogether because they feel stupid. They don’t bother to talk because people are always telling them they’re wrong–that Reagan isn’t President anymore, that their kids are no longer in college, or that it’s January and not May. Or maybe they stop talking because it’s hard work.
Sometimes I walk away from Dementialand with some amazing nugget of wisdom that came from a person who has no idea what year it is or their spouse’s name. This happens quite a bit, actually. I got my best advice on marriage from a guy with dementia who told me he had been married for 30 years. What I learned later is that he left his wife after 35 years and he then married a MUCH younger woman, but he didn’t remember that. His daughter told me. I decided to buy into his advice anyway. It was, “Marry someone who laughs at the same jokes that you do.” Somehow, it’s stuck with me.
I never know what to expect from conversations in Dementialand.