When it happens
Severe dementia. Early in the severe stage, your loved one may speak noticeably less than before. By late (end-stage) dementia, you may hear fewer than four to six words a day.
Why it happens
Communication is a complex process that's been diminishing over time; this is the end of that process.
What you can do
Follow routines in order to better help you anticipate needs (for food, toileting help, being moved) that the person can no longer articulate.
Tune into the emotions being expressed when words fail. You can often sense a difference between someone who's happy or in pain, for example. Likewise, your emotions can be sensed; staying positive is helpful.
Pay closer attention than ever to body language (holding a sore leg) and expressions (grimaces, frowns).
Consider installing a baby monitor in the room at night to help you hear moans or calls signaling a need for help.
Don't mistake a lack of speech for a lack of feeling. Someone with severe dementia still has strong emotions and deserves as much attention, respect, and love as before.
Make your own communications easy to understand: Speak clearly and slowly; use a slightly exaggerated emotional tone to express happiness or concern; approach your loved one from within his or her line of sight, rather than from behind so you don't startle him or her.
Communicate with other sounds: Play music, set up a bird feeder that can attract singing birds (heard through a window), play CDs of tropical sounds or waves, hum. Sometimes even someone with severe dementia responds in kind to singing and humming.
