Compassionate Communication
By The Rev. Patricia Horkey
July 14, 2015
July 14, 2015
“Stand up in the presence of the aged, and show respect for the old;
thus shall you fear your God. I am the Lord.”
(Leviticus 19:32)
thus shall you fear your God. I am the Lord.”
(Leviticus 19:32)
An individual with Alzheimer’s disease continually experiences a decline of memory; as a result of this, the individual suffers the loss of being connected with others. It is important for clergy and lay ministers to understand, that individuals with Alzheimer’s disease live with ‘“cognition decline, [however,] feelings and states of emotional stress remain.”’ Hence, the individual experiences each moment as an identity loss, beginning with the development of Alzheimer’s disease to the individual’s last breath. (Kenneth J. Doka, “Grief and Dementia”)
There are three distinct stages for someone diagnosed with Alzheimer’s: The mild stage, moderate stage, and the severe stage. In the mild (beginning) stage of Alzheimer’s, the person may recognize that there is something amiss with reasoning and start to experience “memory lapse, poor judgment, and gaps in receptive or expressive language.” In the moderate stage, the individual continues to experience difficulties in short and long term memory, making rational decisions, and the deterioration of verbal skills is becoming more prevalent and serious. At the severe stage the individual’s “cognitive impairment is beginning to increase…to severity,” and this continues until death. (Lawrence T. Force, “Grief Therapy for Cognitively Impaired Individuals”).
By understanding the stages experienced by a person with Alzheimer’s disease as well as having an awareness of the percentage of the populace in America who will be diagnosed with this disease both clergy and lay ministers will be challenged to develop skills to effectively communicate with their members and non-members who have been diagnosed with Alzheimer’s. The Alzheimer’s Association counsel is that effective communication begins as “compassionate communication.” Compassionate communication begins with an awareness that people with Alzheimer’s/dementia have “difficulty expressing thoughts and emotions; they also have more trouble understanding others.”
People with Alzheimer’s are afraid at all times and they continually need reassurance that they are safe. For this reason, when clergy and lay ministers are ministering to someone with Alzheimer’s/dementia, it would be helpful to integrate the following strategies in order to nurture compassionate communication:
When clergy and lay ministers implement these strategies they offer a precious gift to those who have been diagnosed with Alzheimer’s disease/dementia, the gift of having a voice!
It is also vital for clergy and lay ministers to understand that “Consciousness is not the mind, it is our being” (Dean Sharpe medical doctor and consultant for the Sacred Art of Living Center for Spiritual Formation). Therefore, the liturgical ministry that is offered to people with Alzheimer’s/dementia by the clergy and lay ministers is essential for the hope and spiritual healing of each person.
There are three distinct stages for someone diagnosed with Alzheimer’s: The mild stage, moderate stage, and the severe stage. In the mild (beginning) stage of Alzheimer’s, the person may recognize that there is something amiss with reasoning and start to experience “memory lapse, poor judgment, and gaps in receptive or expressive language.” In the moderate stage, the individual continues to experience difficulties in short and long term memory, making rational decisions, and the deterioration of verbal skills is becoming more prevalent and serious. At the severe stage the individual’s “cognitive impairment is beginning to increase…to severity,” and this continues until death. (Lawrence T. Force, “Grief Therapy for Cognitively Impaired Individuals”).
By understanding the stages experienced by a person with Alzheimer’s disease as well as having an awareness of the percentage of the populace in America who will be diagnosed with this disease both clergy and lay ministers will be challenged to develop skills to effectively communicate with their members and non-members who have been diagnosed with Alzheimer’s. The Alzheimer’s Association counsel is that effective communication begins as “compassionate communication.” Compassionate communication begins with an awareness that people with Alzheimer’s/dementia have “difficulty expressing thoughts and emotions; they also have more trouble understanding others.”
People with Alzheimer’s are afraid at all times and they continually need reassurance that they are safe. For this reason, when clergy and lay ministers are ministering to someone with Alzheimer’s/dementia, it would be helpful to integrate the following strategies in order to nurture compassionate communication:
- “[Be aware] of your feelings and attitude.” Your feelings and attitudes will be transmitted to the person with Alzheimer’s/dementia. For example, clergy and lay ministers may be feeling that offering rituals, sacraments, and sacramental rites to an individual with Alzheimer’s/dementia is a waste of time, because that individual may not understand or remember; that hesitant attitude will be transmitted to the individual with Alzheimer’s/dementia
- “Treat the person with dignity and respect,” by “avoiding talking down to them or talking as if they were not there.”
- “Identify yourself [and] call the person by name.” This helps ensure communication and a sense of identity, especially if done while looking into the eyes of a person with Alzheimer’s/dementia.
- “Use short, simple words and sentences” with repetition, clarity, and a gentle voice. This will help the person with Alzheimer’s/dementia who may be struggling to comprehend your words.
- “Patiently wait for a response” from the person who may need a moment to understand your question formulate a response.
- “Give visual cues” by modeling an action or touching an item. This will help show the person with Alzheimer’s/dementia what you would like them to do or what you are talking about.
- “Turn questions into answers [and] turn negatives into positives.” For example, “instead of asking, ‘Do you want to pray?’ [try saying], ‘Let’s pray.’ Instead of saying, ‘Don’t shout out loud!’ [try saying], ‘Let’s listen.’” (Alzheimer’s Association and Liz Ayres)
When clergy and lay ministers implement these strategies they offer a precious gift to those who have been diagnosed with Alzheimer’s disease/dementia, the gift of having a voice!
It is also vital for clergy and lay ministers to understand that “Consciousness is not the mind, it is our being” (Dean Sharpe medical doctor and consultant for the Sacred Art of Living Center for Spiritual Formation). Therefore, the liturgical ministry that is offered to people with Alzheimer’s/dementia by the clergy and lay ministers is essential for the hope and spiritual healing of each person.
Our next article will explore our liturgical ministry and sacramental rites in service to those living with Alzheimer's disease/dementia.
Patricia Horkey, our Nominee for Ordination to the Priesthood in the Episcopal Church, is helping me and our parish develop a ministry to elders, especially those living with Alzheimer's disease or dementia. ~daniel rondeau, vicar
