When Words Are Few

(Time Period: Throughout Mom’s time in the care home.)

Conversations & Comprehension

In the first several months of memory care, Mom still conversed fairly well. Over time she spoke less, though she enjoyed listening to conversations. Paragraphs of speech were reduced to single sentences, often punctuated with a smile, laugh, or nodding of her head to demonstrate she was tracking with us.

When attempting to assess her comprehension, there were contradictions. Speaking, writing, and reading were each different. For example, along with other children’s toys that were available for residents to use, there was an Etch A Sketch. It was unnerving to see “Grace” misspelled by Mom, once a teacher with an expansive vocabulary. In capital letters she had written: “GRECE.”

Underneath were four lowercase letters: “xxxx.” I wondered, “Are these indicating kisses or just random?”

On the third line was a word that began with the letter “M.” I thought, “Is she trying to spell Mom?”

Grace could still read, however, and sometimes when Mom read out loud, I was surprised to hear her use a word that I thought was filed away and unable to be retrieved. I came to understand that though she could read many words, it was comprehending their meaning that was difficult for her.

Mom’s Etch A Sketch

Assumptions & Adaptation

Relatives and friends mailed Mom letters periodically which I would read to her. As time went on, I abbreviated the message if I noticed there was too much detail for Mom to absorb. She especially enjoyed receiving cards from her granddaughters. When I noticed she was struggling to read the note in its entirety, I suggested to my niece Mary Grace that she adapt the message to include one main thought and to write that sentence in larger handwriting.

This did the trick. Mom and I would open the card and read together:

Hi, Grandma. It’s a sunny day here and I’m thinking of you. I love you very much.

This simple message with fewer words was one Mom could comprehend. She enjoyed these shorter notes that were easier to read.

Rather than going by hard-and-fast assumptions, I learned to respond in real time. For example, it astounded me that she was able to read a framed embroidery of the 23rd Psalm, The Lord is My Shepherd. It hung on the wall in her bedroom and for a time, Mom seemed to be comforted by having it there. I was amazed that she could read the words, however at a certain point, I detected that it became a source of stress. She would stumble over a difficult word or read a line repeatedly, trying to grasp its meaning. Leaning forward from a reclined position in bed, she would strain to reach for the embroidery on the wall.

I relayed this observation to my sister Lori who concluded: “The psalm has to go. Time to take it down.” We replaced it with a picture.

Making adjustments at the right time was what I aimed for and trusted we would do. I learned to expect the landscape to change and to be confident that we would respond to the new stage just as we had done with the prior one.

Embroidery of Psalm 23 in Mom’s room

The Exchanges That Stay With Us

On occasion, Mom’s choice of words was humorous. One Sunday we brought an ice cream cake to share with everyone in the home. Jess and I carved the cake and served it to Mom and the ladies sitting with her in the family room.

Jess sat down next to Mom to help her eat. After two small bites of ice cream cake she stated, “I’m full.” We cleared her plate, re-boxed the remaining cake and stored it in the freezer.

Jess returned to his seat to hear Mom say, “I’d like to have a little cake.” Back to the freezer he went to cut a fresh piece of cake. Again she had one bite and indicated she was full. Jess returned the cake to the freezer.

After about twenty minutes of conversation with the group, Mom directed a comment to Jess, “Eventually, I’m going to get my cake.” Now catching on to this routine, Jess assured Mom that he saved her a big piece to have after dinner with dessert.

Mom’s use of the word “eventually” was delivered with impeccable timing. We did not know she still had access to that word and combined with Jess having gotten up and down to reopen the box of once-frozen ice cream cake, it struck us as funny. This “eventually” line still makes us chuckle and we use it with each other at home. Eventually, someone will get me my coffee.

Another instance when Mom surprised us with her choice of words was on Christmas Day. We were opening gifts and Jess was helping her manage the ribbons and wrapping paper. As the lettering on the box became visible she exclaimed softly, “Ooh, Talbots.” Mom had forgotten a lot of things but apparently remembered that Talbots was a nice store.

These kind of surprises tickled us and taught us that Mom often retained more than we realized.

Jess helping Mom unwrap Christmas gifts

Getting to the Heart of Things

Sometimes Mom’s words were jumbled and impossible to translate, We could not always understand what she was trying to communicate.

There were days with very little conversation yet as her words became sparse, they took on more significance. I started recording things she said in my journal. Certain exchanges were tender.

Mom: “I see your face.”
Me: “And I see yours.”

Mom: “You’re my little doll.”
Me: “And you’re my doll.”

Me: “I love you.”
Mom: “I love you, too.”

The simple back and forth was reassuring to us. The words might have been fewer and the sentences shorter but the exchange was deeper. This would continue into the later stages, with some of our most poignant communication occurring in her final weeks and days.

In our everyday lives, we use many words unnecessarily. We chatter away or prolong making a point. Things change when words become less accessible. When much is stripped away, what remains is the most important part.

Grace reading a card from her granddaughter