“Give me a hand” and other confusing statements

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Harry sat in his wheelchair, pushing and pulling himself forward and backwards using his feet. He was restless, and in a late stage of dementia. 

Harry spotted me. “Hey, blondie!” he called out. I laughed and turned around.

“Yeah, Harry?” I responded. 

“Will you give me a hand?” he asked.

“Sure—with what?” I said, walking towards him.

“With yours,” Harry explained, outstretching his hands.

This wasn’t the first, nor the last, time that I watched someone with dementia take a figurative statement and make it literal. 

I saw the same thing happen during a cognitive evaluation last week. The doctor was asking her client a few orientation and memory questions. 

“Now, if I said, ‘Can you lend me a hand?’ what would I mean?” she asked. Her patient, without even thinking, outstretched his hand to her.

Many people, especially with certain types of dementia, have trouble understanding figures of speech. The phrase, “Hop in the shower” may result in someone actually jumping into the tub. One thing that I caution caregivers against is using the word “let’s” when they are talking to someone with dementia. For example, saying, “Let’s take a bath now,” may result in the person with dementia assuming you’ll also be joining them in the tub.

Communicating with someone who has dementia can be tricky sometimes, but it helps if we know little points like this.

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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