Imperial, California - When you try to communicate with a loved one living with Alzheimer's disease, you may feel like you've dropped through the rabbit hole into Alice's wonderland.

Because Alzheimer's disease slowly erodes verbal communication skills, your loved one's words and expressions may make little or no sense to you. In turn, your loved one may have trouble deciphering your words. The resulting misunderstandings can fray tempers all around, making communication even more difficult. Here's help easing the frustration.

What to expect

Alzheimer's damages pathways in the brain, which makes it difficult to find the right words and to understand what others are saying. Your loved one may incorrectly substitute one word for another or invent an entirely new word to describe a familiar object. He or she may get stuck in a groove - like a skipping record - and repeat the same word or question over and over. 

A person living with Alzheimer's may also:

• Lose his or her train of thought
• Struggle to organize words logically
• Need more time to understand what you're saying
• Curse or use offensive language

What you can do to help

Despite the challenges, you can communicate effectively with a loved one who has Alzheimer's. Consider these tips: 

• Speak clearly. Introduce yourself. Speak in a clear, straightforward manner.
• Show respect. Avoid secondary baby talk and diminutive phrases, such as "good girl." Don't assume that your loved one can't understand you, and don't talk about your loved one as if he or she weren't there.
• Stay present. Maintain eye contact, and stay near your loved one so that he or she will know that you're listening and trying to understand.
• Avoid distractions. Communication may be difficult — if not impossible — against a background of competing sights and sounds.
• Keep it simple. Use short sentences and plain words. As the disease progresses, yes-no questions may work best, and only one question at a time is best. Break down requests into single steps.
• Don't interrupt. It may take longer than you expect for your loved one to process and respond. Avoid criticizing, hurrying and correcting.
• Use visual cues. Sometimes gestures or other visual cues promote better understanding than words alone. Rather than simply asking if your loved one needs to use the toilet, for example, take him or her to the toilet and point to it.
• Don't argue. Your loved one's reasoning and judgment will decline over time. To spare anger and agitation, don't argue with your loved one.
• Stay calm. Even when you're frustrated, keep your voice gentle. Your nonverbal cues, including the tone of your voice, can send a clearer message than what you actually say.

Communicating with your loved one may be challenging, especially as the disease progresses. Remember, however, your loved one isn't acting this way on purpose. Don't take it personally. Use patience and understanding to help your loved one feel safe and secure.