Rose sits in the lounge chair. The morning rays of
sunlight shine on her face, illuminating her once bright, blue eyes. A
person greets her, “Good morning Rose.” Rose doesn’t respond, doesn’t
recognize this person who is greeting her.
Morning follows morning, day follows day at
Memory Care Manor where Rose now lives. Family photographs hang
on the wall, persistence of a memory long ago. Rose sits
waiting, waiting for Jack, her husband, who is coming for a
visit. And when he enters the lounge, prepared to assist his
wife of 57 years with her breakfast, Rose displays no apparent
recognition of him.
Rose remains motionless, eyes fixated. This
could mean that she no longer knows her husband. Or it could
mean that she doesn’t wish to violate the etiquette of Memory
Care Manor with an enthusiastic greeting, which may be
interpreted by some as inappropriate. Or it could mean that the
acceptable response to a “Good morning,” from Jack, is a
However, Jack finds encouragement in this
lack of reaction. He continues to prepare Rose to eat her
breakfast. Jack is not surprised. He knows that Rose has
Alzheimer disease. What Jack doesn’t comprehend, is why his
darling wife of 57 years, no longer speaks to him.
Jack lives close by Memory Care Manor. This
day, following his visit with Rose, Jack visits the public
library. He has decided to tackle head-on, his own research of
learning to speak Alzheimer disease. In the library that day,
Jack learns that in 1906, Dr. Alois Alzheimer examined a slice
of brain tissue under the microscope, identifying plaques and
tangles surrounding the brain cells, a hallmark of Alzheimer
disease. As a result, there may be mental deterioration. Jack
learned that the person affected, his Rose, may no longer be
able to communicate as they previously could. Due to the mental
deterioration, the language center of the brain may be affected.
Consequently, the person has difficulty understanding, or being
understood. Jack begins to realize that Rose is doing the best
The next morning, Jack arrives early at
Memory Care Manor, armed and ready with his new found knowledge.
Rose is sitting in her familiar place in the corner of the
lounge at Memory Care Manor, motionless, waiting, waiting,
When Jack enters the room with a cheery
“Good morning,” he makes a special point of warmly embracing his
wife. He then asks the caregiver if she might play a soft piece
of classical music (Rose’s favorite) on the stereo. Jack moves
Rose’s lounge chair to a quieter corner of the lounge, removed
from the other noises and distractions. He then brings Rose’s
breakfast tray and sits with her, preparing to feed her
“Here my Rose, have some porridge,” says
Jack, offering a spoonful to Rose’s lips. No reaction. This does
not discourage Jack. He takes Rose’s hand and holds it, as he
offers a second spoonful of porridge. This time, Jack notes a
special little smile around Rose’s mouth as she swallows the
cereal. Something else he notices, is that Rose’s body language
is more relaxed. She is listening to the classical music softly
playing in the background.
Jack leans forward, closer to Rose and says,
“Does my Rose love me?” At first, no response. And then, Rose
also leans forward, puckering up her lips for a kiss. Jack
responds in kind with a kiss. Once again, Rose puckers up her
lips and leans forward. Jack smiles and says, “My Rose wants two
The interview with the husband follows:
Jack, when did you first notice that
something might be wrong with Rose?
It was a gradual thing. Rose had short-term memory loss and this
was distressing for her. She couldn’t seem to remember from one
minute to the next what she had done and not done. She would
tell our daughter a story of something that had happened, and
then five minutes later, she would tell the same story.
It is interesting that in spite of the
fact that Rose doesn’t speak to you, you still remain so
positive. Could you comment on that?
I can see her brightness vanishing, but I love Rose because she
is so loveable. Nothing can ever change that. Not even this
Alzheimer’s disease. I believe that Rose’s spirit is alive and
well, in spite of it all. This keeps me going.
And you mentioned she had a special
little smile that morning. What do you think she was thinking?
Rose and I met on Valentine’s Day. That same piece of classical
music was playing when we met. And that morning when the girls
played the music, and I saw Rose’s little smile, I really
believe that she is remembering too.
When Rose sits there in her chair, larger
than life, you must feel wistful for days gone by. Do you want
to talk about those feelings?
Well, yes, I’m pretty attached to my memories with Rose. We’ve
been married for 57 years. That’s a lot of years and a lot of
memories. I guess though, I’m coming to a place where I feel
like Rose and I can still have a life without those memories. I
know that sounds kinda strange, but I tell the kids, “Mom and I
are making new memories every day.”
Jack, how do you handle it when Rose no
longer recognizes you?
It makes me sad. I tell myself, this disease is not about me.
But I can’t help my feelings. Rose has always been so vibrant
and alive and chatty. These days she is in her own little world.
You mentioned you had done some research
on the subject at the public library. Was this information
useful for you?
I’ll say. I was reading about the mental deterioration and the
fact that the brain size is actually shrinking, and about the
plaques and tangles surrounding the nerve cells of the brain. I
can understand that the language centre of Rose’s brain may be
affected, and this is why she no longer speaks to us. I
mentioned before I believe Rose’s spirit is alive and well, in
spite of the Alzheimer’s. I believe my Rose is still in there,
and when she doesn’t speak, she is swallowing her feelings.
How do you deal with the silence?
I now understand that Rose is doing the best she can. It’s hard
sometimes because I’ll be talking to Rose about a memory or
something we’ve done together with the family, and I pause,
waiting for Rose to respond like she always has. And there’s
silence. That’s hard to take.
What are some of Rose’s favorite things?
And is she still able to enjoy some of these things?
Rose always had incredible energy and creativity. She spent
countless hours with the children, of course she was a mother
first, but Rose was very involved in community and school
committees. And she loved to entertain. Rose was always busy
helping others. Today, Rose still loves having people around
her. And she enjoys listening to stories.
Let’s talk about you for a moment Jack.
What things do you do to take care of yourself?
I read a lot. And I enjoy walking. I’m here at Rose’s side every
day, and when the weather warms up, I’ll take Rose outside to
the garden. We always enjoyed working in the garden together. I
What did you feel in that moment when
Rose puckered up for a kiss?
Our eyes connected briefly just before the kiss, and I thought
to myself, “I’ve got my Rose back once again.” I was so
astonished; I hugged her and said, “we really do love one
another, don’t we Rose?”
Your journey with Rose has encouraged so
many. What do you tell people who are angry?
I tell them that there is help and there is hope. I haven’t
worked it all out yet. I’m struggling. But on the good days, I
know that this Alzheimer disease has happened to my Rose for a
reason. And I’m grateful that we have this time together.
Communicating with the person with dementia can prove to be one
of the greatest challenges. This individual may no longer
communicate with words. Rather, they communicate with feelings.
Because of this, frustration levels can run high, both on the
part of the person with dementia and their caregiver. The
communicated message may not be received or understood. The
person with dementia may not be able to express themselves or
even complete a simple sentence.
Jack truly believes that Rose’s spirit is
alive and well. Sometimes, this is the only hope that families
When caregivers face this situation, they need to first assess
who is this person? Although the individual may not be speaking,
their body language is alive with feelings. Is the person happy,
sad? Are they moving around in an agitated manner? What are the
eyes saying? The eyes are the ‘windows of our soul.’ Jack has
learned to read the message in Rose’s eyes and her relaxed body
language. Jack discovers that he needs to pay particular
attention to Rose’s facial expression, as he notes “a special
little smile around Rose’s mouth…………”
Putting it all Together
A large part of communicating with anyone is related to ‘the
knowing.’ Knowing who this person was prior to the dementia.
Jack knows that Rose loves classical music. He knows about her
personhood, and her sense of self? When caregivers have this
information, they are then able to embrace who Rose is, and to
understand her emotions so much better. This truly enhances the
communication process, empowering both the caregiver and the
- gentle touch
- understanding the body language
- knowing the person
What Doesn’t Work:
- noisy environment
- rushing the person
- don’t talk about them in front of them
- There’s Still a Person in There; Michael Castleman, Dolores
Gallagher-Thompson, Matthew Naythons; 1999
- Best Friend’s Approach; Virginia Bell, David Troxel; 2002
- Learning to Speak Alzheimer’s; Joanne Koenig Coste; 2004