I walk you, too. I mean, like.

Sometimes, communicating with my clients is like interpreting someone who's just learning to speak English. The sentiments are often clear, but the words themselves are odd. Whether they're officially diagnosed with dementia, Alzheimer's, stroke, or aphasia doesn't really matter. You've just got to try to listen hard and when all else fails, pantomime. Which is extra fun when what you're trying to communicate is "I'm going to wash your genitals now". It makes pantomiming brushing teeth or sitting down just delightful. Sometimes, though, once you get to know someone's particular brand of language-slips, the pantomimes become unnecessary.

Take the lady in my assisted living facility who has a fairly complicated getting-ready-for-bed routine. Not only do she and her husband BOTH SPEAK AT TOP VOLUME ALL THE TIME, but the words that substitute in her brain are often just barely related to what she means. She'll gesture at the door, telling me to leave the wicker a little bit open. She'll ask me to bring her wire, pantomiming holding a walker in front of her. She'll tell me she'd like a drink of can. But once you get used to her, it's fairly easy to tell what she wants.

At the other end of the spectrum, I have a homecare client whom I bathe 2x/week. Originally from Japan, and currently on pain mends that increase her confusion, her conversation tends to be a mix of Japanese and English that's largely unrelated to what's happening around her. Luckily, she's a friendly and easygoing type, and that is making her life much easier now that she's got others doing things for (and to) her all the time. My favorite is when I ask her "are you cold, or ok?" and she'll gaze around the room slowly, then finally make eye contact with me. I can see she's hearing and understanding me, and I'm pleased we're communicating. And then, impossibly slowly, she'll ask "Are ... you ... talking ... to ... me?". I smile and say yes, waiting for an answer about her comfort level. And instead I'm rewarded with a smile back and an "Oh ... thank you!".

Both of those pale in comparison to my now-foulmouthed ex-Navy fella, Jimmy. Jimmy has Alzheimer's, and is just getting to the stage where he begins to substitute inappropriate words for appropriate ones. The best part about Jimmy is that when he says something shocking, and I say "Jimmy! You said you wouldn't talk to a lady like that!" he is genuinely contrite. Not because one shouldn't ask "Does she like to f**k?" about someone he's never met, or talk about whores in a doctor's waiting room. Nah, Jimmy is just surprised and sorry that apparently those things have just recently become "not nice things to say".

I love all my goofball clients. They may not have words or manners, but they make themselves understood and I can tell that they walk me too. I mean like. They like me too.

And just to show you I didn't make all this up:

(thanks, wikipedia!)
and to help you understand that brain picture:
"Why Swearing?" by dementia expert Teepa Snow