Skip to 0 minutes and 9 secondsHe's had a diagnosis of Alzheimer's disease for about seven years and his dementia has progressed over that time from being mobile and quite independent, but perhaps lacking understanding about the risks to himself, to now being totally dependent on staff to meet all his care needs. His communication skills and his understanding were affected quite early on in his dementia. His verbal communication is-- he occasionally says the odd word, but there's practically no verbal communication at all. If he does say a word, it's normally indicative that he's not happy. So he might say out or no. But though sometimes I think no is used just as a word that he can say, so it might not always mean no either.

Skip to 1 minute and 1 secondCognitively, Jack didn't have an awareness of where he was when he first came into care, wasn't aware of risks to himself within the home. He did recognise the family, and the family would spend long periods of time with him, which he thoroughly enjoyed. He would function still at a level where he was able to recognise the need for a toilet recognise, and sort of the need to eat and drink, and sit and have good social skills at meal times. But communication was starting to deteriorate quite early on, and he would often say no, and no didn't always mean no. But you knew when no meant no, it really did mean no.

Skip to 1 minute and 52 secondsAnd that was because it was backed up by his facial expression, and his nonverbal communication. His orientation, he didn't really know his way around the home. And again, as his illness has progressed, he's become perhaps less orientated. But because his communication now really is limited to no, it's quite difficult to assess where he is with regard to his memory, and his understanding of what is happening. One of the things that was really beneficial within those discussions was to talk about what a dad's world looked like to him. When he was in bed, what did he actually see? And we found that from his perspective, he couldn't actually see the television.

Skip to 2 minutes and 40 secondsSo the television was moved straight away by the care home, which was great. He couldn't necessarily follow a programme, but what we did know, he used to respond well to canned laughter, and that would make him laugh. So again, when he was in the recliner chair, what did he see? Because his vision of the world obviously wasn't ours, because we could move around. And another factor, I think that was quite powerful that I could negotiate between the family and the care home, and support both parties in ultimately pulling the care together to offer the best care for their dad.

Skip to 3 minutes and 18 secondsThough there is still emotional connection, so sometimes when I'm playing music or I'm singing, for example, I can see sometimes his eyes filled with tears, and I sense that there's a deep emotional connection there. And occasionally, if I'm being really stupid, which is obviously quite often, he does a slight sort of like shake of his head as if to say, honestly. And again, I feel like I'm speaking to him then, even if it's not in words. It's a really social thing, I think music. And it's a way to help us to communicate, and I think that we are able to communicate. It's just in a different way to the way that we used to do.

Jack’s story: memory, thinking and communication

In this first part of Jack’s story we look at changes in his memory, thinking and communication and how his needs changed.

His daughter, a nurse specialist and care home staff describe how Jack’s ability to communicate changed and how they adapted to communicate with him to maintain his emotional needs.

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This video is from the free online course:

Dementia Care: Living Well as Dementia Progresses

Newcastle University