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Sunday, November 3, 2013

Losing Human Expression

Spirits still burn brightly in bodies that lack means of expression. I have seen how age befuddles and stupefies those who become victim to its unkind grip. As time takes a toll on flesh, the spirit rebels, confident that human will can overcome the deterioration of body and mind. And, many times, the will does succeed to slow the tempo, yet nothing can stop even one moment of aging.

Normal aging brings about dramatic physical, psychological, and social changes. I know few of these changes are easy for people to accept and most debilitate their host in some way. Aging equates to losing, and some accept the decline more gracefully than others. We all hope to travel the imminent  road of wear with a pleasant demeanor. Unfortunately, many of us lose the reins and must rely upon others to help us through our senior days. 

I am convinced that the most cruel aspect of aging involves the inability of humans to express themselves. The ability to communicate is the most human characteristic. When a person finds it impossible to communicate his or her thoughts effectively through verbal or written language, that person becomes imprisoned from within. Uncontrollable forces block and even lock dissemination.

How frustrating it must be to lose the capacity to write or the ability to carry on a fluent conversation. I can only imagine how frightening it must be to realize that no one understands you because "your words won't come." You are muted yet conscious of your inner voice.

When people experience great problems with communication -- difficulty in finding words, inability to speak plainly, failure to comprehend meaning, frustration with expressing emotions -- they find themselves struggling with most everything they encounter in their normal day.

Medicine can explain how diseases such as Altzheimer's, Parkinson's, hypertension, diabetes mellitus, and cardiac disease have negative effects on cognition, especially on executive function and working memory, and that decline in executive function has negative effects on specific aspects of language in aging (namely, lexical retrieval and auditory comprehension). Yet, medicine cannot guarantee a person will age with a clear mind, a brain capable of expressing its precious content.

It is estimated in American nursing homes 60% to 90% of residents may actually have communication disabilities. These disabilities commonly include apraxia, a motor speech disorder that is caused by damage to the parts of the brain related to speaking. And, apraxia can occur in conjunction with dysarthria (muscle weakness affecting speech production) or aphasia (language difficulties related to neurological damage.

People suffering with dementia experience a gradual lessening of their ability to communicate. They find it more and more difficult to express themselves clearly and to understand what others say. Yet, it is important to understand that each person with dementia is unique and difficulties in communicating thoughts and feelings are very individual.

People retain their feelings and emotions even though they may not understand what is being said or how to respond to what is being said, so it is important to always maintain their dignity and self esteem. Never be condescending to a person with dementia. Arguing with this senior, ordering them around, or telling them what they can't do frustrates them and is largely counterproductive.

Perhaps the worst treatment of someone who cannot effectively communicate is to talk about that person in front of them as if they are not there. Doing this effectively dehumanizes a personality. The person understands that he or she is an object of avoidance rather than a being deserving concern and understanding. 

According to the U.S. Census Bureau, by the year 2030, a projected 71 million Americans will be age 65 or older, an increase of more than 200 percent from the year 2000. It is estimated that 10,000 people turn age 65 every day. That means we must make great strides in understanding those in peril of losing the ability to communicate. The seniors have much to say but too often we deny their voices. A start would be to listen to them and to assist them, rather than to ignore their opinions. Slower tongues and pens may be valuable tools in a future filled with more and more older citizens.

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