"The onset of dementia will usually affect the part of the brain that deals with language. This means that there will now be significant and increasing deterioration in the person’s level of verbal ability. The ability to both understand and use words and language becomes impaired. Additionally, because the part of the brain that we use to identify the geography of our body also becomes damages, people who had previously used sign language, such as Makaton, will find it harder to use them.

For most of us only 20 per cent of our communication is verbal while 80 per cent is non-verbal, that is touch, tone of voice, facial expression, gesture and body language. Someone with a learning disability may already have difficulty with verbal skills and so be heavily reliant on non-verbal information. This reliance is increased by the onset of dementia. With the impairment of verbal communication skills the non-verbal communication becomes even more important. People with dementia will become more aware of the emotional content of any exchange. This can easily lead to severe communication difficulties, caused by the carer relying on verbal cues whilst the person with dementia is responding to body language and facial expression.

 

Case Study

Hannah, a 49-year-old woman with a learning disability and dementia, is sitting in the hall waiting for the bus to take her to the day centre. She calls her support worker over to help her with her coat. The telephone rings and her support worker says, ‘I am just going to answer the phone, Hannah, I will be back in a minute.’ Hannah does not understand the words: what she knows is that her worker has turner her back, walked away and ‘abandoned’ her. Hannah starts to shout and pushes another tenant as he passes her. Although the worker has promised to return and help Hannah, the message Hannah has received is that she has been abandoned. The non-verbal communication has not been mitigated by the verbal reassurances.

Carers will be familiar with similar situations where their words of support or concern are not heard but the person with dementia responds to their stressed facial expression or their body language.

Staff and caregivers must be alert to the non-verbal cues and communication given by the person with dementia. Malcolm Goldsmith (1996) comments: ‘it is probable that many opportunities are missed because carers are not sufficiently skilled at recognising and interpreting non verbal communication’. This tendency is probably exacerbated by the attention given within the learning disability service to behaviour that challenges. There is a danger that non-verbal behaviours in people with dementia will be seen as evidence of the extension, development or reappearance of challenging behaviour rather than the attempts of a person struggling to communicate.

It is important to remember that the person with dementia will feel increasingly out of control and confused by their environment. This will increase their stress levels and will in turn make finding the right words or phrases more difficult. It is essential, therefore, that all communication is conducted in a stress-free environment. This involves managing not only the physical environment but also our own behaviours and unintended messages."


The above is an abstract from Diana Kerr’s book Understanding Learning Disability and Dementia, Developing Effective Interventions (2007).

Diana will come to Ireland to present a seminar, entitled, ‘Supporting People with a Learning Disability and Dementia’, on Thursday 19th November 2009. The above abstract will give you a flavour of some of the topics she will be covering on the day.

The seminar takes place in Fitzpatrick’s Castle Hotel, Kiliney, Co Dublin on Thursday 19th November 2009, from 9.30 am (registration from 9.00 am) until 4.30 pm.

The cost of the day long seminar is €95, which includes a light lunch and a tea/coffee break.


For further information please see: Supporting People Learning Disability Dementia

To book a place at the seminar you may phone our office on 01 661 8000 or alternatively you can click on our ‘Visit Our Shop’ button on our home page where you can pay via Paypal.

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