Why Does She Sound Fine on the Phone and not in Person?

1 answer | Last updated: Sep 12, 2016
Pupdogs2 asked...

My aunt is 83, in person she is sometimes confused at what is said, repeats herself, asks the same questions. Yet on the phone you would never know the situation is as severe as it is. She just sounds like anyone else.

Expert Answers

For 20 years, physical therapist Connie Lambert has worked with individuals and families with Alzheimer's disease and dementia. As founder and CEO of Our Generations, LLC, she provides specialized dementia and behavioral management training for corporations, facilities, and groups.

Talking on the phone and in person are two very different skills. Often the elderly individual can better control the environment while on the phone, meaning fewer distractions. When talking on the phone your aunt is required to process only your voice. When talking in person there is a great deal more sensory information that she is required to process. She must process visual input, body language, environmental cues, process what you are saying as well as determine her response. Even in the most controlled environment where she feels comfortable and distractions are minimal she may feel more pressure to present a certain appearance. The presence of confusion and repetitive questioning becomes readily apparent in face-to-face conversations. Families are often shocked by the difference between phone conversations and the in-person reality. The confusion and repetitive questioning may be a sign of cognitive loss or dementia. But, there may be other metabolic reasons. The degree of the loss and her ability to function safely within her environment are concerns that should be addressed. Often, with a little help, individuals such as your aunt are able to age in place. Your aunt is fortunate to have you. My best wishes for success.