Carol Howell Talks Dementia: Word Salad

Momma’s Alzheimer’s continues to do its nasty stuff to her brain. She has declined quite a bit in the last two months, and it is painful to watch. I’ve had to have some pretty difficult conversations with her recently and it’s been horrible. I told her it’s not safe for her to go behind the wheel anymore and she was upset about losing her freedom, it’s for the best though. I’ve even thought about taking her to a care home so that she can have the care she deserves but I haven’t had that conversation with her yet. It’s been really nice talking to her and learning new things about her childhood and life stories. However, one of the things I have become more aware of is Momma’s “word salad” experiences. Let me explain.

We all know what a tossed salad is. You take lettuce, cucumber, tomatoes, cheese, bacon bits (every salad needs a few bacon bits), cauliflower, salad dressing and toss them all together. You then you have a wonderful salad to enjoy. I’m making myself hungry thinking about it!

When your fork enters the salad bowl to retrieve a bite, you don’t know which of the various ingredients will be on your fork when it is removed. It may be just lettuce, or it could be lettuce and any of the other tasty additions to the salad. It would be very difficult to retrieve only bacon bits or only cheese while eating that salad. The entire point of a mixed salad is to get a variety of tastes with each bite.

When an individual with dementia is in the later stages of their disease, they may experience “word salad.” All the words in their vocabulary are tossed together. They try to retrieve a specific word, but they come up with everything except the word they want. I’m sure professionals from places similar to Banfields are all too familiar with support people with this kind of issue. Thinking back to our tossed salad, they may have wanted bacon bits, but they retrieved cucumbers!

Think about how easy it is for you to verbalize your thoughts. Now imagine that every sentence you constructed was missing two or three or four very important words. Just saying, “I want to go shopping to buy groceries” might come out as “I want to… you know go…because I need…oh I can’t remember, but I need….maybe we can go.” There is much confusion and frustration for the individual, and you, the caregiver, have no clue what they wanted. It is at this point that you must be patient. I will admit it is difficult to be patient, but you have to be. Your loved one is dealing with enough anxiety, and they don’t need your anxiety added to theirs. A good response would be, “I agree. We need to go. As soon as I can work out the details, we will go. Where would you like to go? Grocery shopping, maybe?”

Another idea is to give your loved one a paper and pen to see if they can write any of their words. It might surprise you what they were actually trying to say.

My Momma is fairly good at sentences until about 4:30 in the afternoon. Sundowning strips away her verbal abilities, and sentences are no longer available to her. It is a frustrating experience for her and her family. We are learning to be patient.

Hope that gives you Something to Ponder.

Photo credit: Taste of Home