If we come seeking to make contact, to be in relationships with people who are living with late-stage dementia, we must believe personhood persists despite cognitive deficits. Lives are not defined by diagnoses. Persons living with advanced cognitive impairment are not empty shells drained dry of the content of their humanity.
Realizing that the ability to communicate effectively with words may have been lost, we must hone our multi-sensory listening skills and heighten awareness of non-verbal cues, aligning ourselves to receive and respond appropriately to these messages. Non-verbal cues may carry emotional content; we should acknowledge and validate this content in our responses.
Our stance should be one of openness, vulnerability, authenticity and non-judgement, and we should expect to find a human being in front of us who has a story that needs to be appreciated. This story, with its history, its present, and yes, its future, is laid out before us in the form of one who needs us to bring our best self to the interaction.
The language of kindness, gentleness, presence, mindfulness, silence, and peace will speak when words fail. Non-threatening touch, being mindful of response, can effectively communicate warmth and good intention. Resisting reactivity, we should validate the emotional content of their expression, but refrain from mirroring anxiety or agitation, instead using smiles, gentle eye contact, soft singing or humming, or props to create a non-threatening environment.
We must quieten the hypercognitive chatter of the world in which we live, seeking instead a state of wakeful stillness and present moment centeredness, opening the all-seeing eye of our inner nature to join the reality of another person’s existence – a person whose inner nature is of the same basic substance as our own. We must dare to embrace our own vulnerability – our own fear of mortality, our own desire for safe anchor in the familiar harbor of home, remembering they have the same deep need for safety and familiarity.
It is essential to understand the importance of reciprocity in this relationship: it cannot be all “give” with no “getting back.” The fire of life inside them can be felt if we get close enough, if we become perceptive and unencumbered enough to feel it. And it will thus kindle our own.
The impact and integrity of this interaction has much to do with our intentionality: we must believe relationship is possible, that communication can occur, that the burden of living can be shared, and that moments of connection matter, even if the main content of this time is silence. Importantly, it is a living, breathing silence, made sacred in the sharing.
We come as seekers, as believers, holding one another accountable only to be as fully human as we can be in whatever physical or cognitive state we may be found. If not already apparent, this exercise has as much to do with seeking the core of our own humanity as it does seeking theirs. Communion is the treasure that awaits.