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Comprehension/ Understanding | Doctor's Diary

Depending on the context in which it happens, when the person you care for has trouble understanding what you are trying to tell them, it can be frustrating, scary or hurtful, or all of these at once. It can help to classify what the nature of their problem is:

Do they not understand the words that you are using? This happens as part of impaired language function, which is most common in moderate dementia.

Do they not remember what you are saying? Does the explanation require much background knowledge? For example, would what you are telling them about Aunt Harriet's boy's second marriage only make sense if the listener remembered what the first wife was like, and how that marriage turned out?

Do they understand what you are saying, but not believe it? This is often seen with delusions, which can happen in mild dementia, but which are more common in moderate or severe dementia.

If the nature of the incomprehension problem is of the first or second - that they do not have the background information, or are losing the language, then it can sometimes be helpful to repeat what you are trying to say. This can be repeated a few times, with simple language, or even with the same words. It rarely helps however, to repeat your explanation if the person you care for is delusional - if they understand, but simply do not believe what you are saying.

See Also:
About Dementia > Alzheimer's Disease > Natural Progression and Staging
Symptom Library > Thinking & Judgment > Following Instructions
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Last updated January 13, 2019
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