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Our ability to carry on a regular 'give and take' discussion is pretty limited. He chose to not learn sign language, therefore, that is not possible. However, over the years we have developed a few hand signs to communicate basic needs.
If you have any involvement in or influence over her care provision, one thing to aim for would be continuity of care so that she is looked after mainly by people who know her preferences and habits well. This is always desirable, of course, but for those whose communication is limited it needs to be stressed as a priority.
You would be surprised at how much communication is non-verbal, and how sensitive people are to small signals. So it's not hopeless - I'm just sorry not to have more to suggest. You could try consulting an Occupational Therapist?
She is alert enough to be able to realize that one or the other garment has not been returned in a few days.....She is amazingly alert and observant.
Grace + Peace,
Having an evaluation from a speech pathologist should be helpful in determining which type your grandmother has and what some solutions could be.
There are a couple of simple solutions. Write he usual needs in large letters on paper or a board so you can point to them and she can communicate her needs. If this does not work draw or find pictures of these things. plenty of catalogs with pictures of things like the toilet, foods coffee, cups etc
Once she said she needed the sour cream on. That meant she needed her brief changed. Other times she'd yell she needed the heat turned UP UP UP and they'd turn it all the way and what she really wanted was down because she was way too hot...and the extra sweater that we added wasn't helping that any.
The speech therapist will try to teach them to compensate when they can't find a word, and if they are willing to use a picture board or point to choices like what foods they usually want or maybe pictures of someone who is too hot or too cold, it can work. If you really have no option to get one, there is no reason not to try some of those things yourself. Here is a site you might like to look at: www.aphasia.org/content/communication-tips - I noticed that googling for "communicate with elders" was not as much help as "communication with aphasia" for the kind of thing you are going through. It's hard.