Using Facial Cues for Patients with Aphasia and Dementia

by Tirzah Wear
Activity Director
Arlington Court Nursing and Rehabilitation

I am currently 3500 feet above the ground flying home from a brief and eventful visit with my Uncle Randy in Houston. Randy was diagnosed with early onset Alzheimer’s two years ago and life hasn’t been the same for any of us since.   Over this summer, his language took a sharp turn for the worse.  As a result, he has become quiet and withdrawn.

Facial Cues Arlington CourtRandy has always been “larger than life”.  He is world-traveled, a fabulous cook, a wine aficionado and always the most interesting person in the room. His personality is magnetic.  As a child, I remember spending visits listening to stories about his wild escapades in Scotland or India, always told with an enormous smile and booming laugh.  I was named after him with my middle name and always secretly hoped I would inherit his uncanny ability to “carpe diem”.

This made it all the more shocking to see him on the periphery of conversations this weekend. He was no longer the ultimate storyteller, but a humble quiet man speaking only occasionally and very few words. His wife told me he has been this way since his language declined over the summer. It broke my heart to see him this way, but he was familiar to me. He reminded me of so many of our residents, sitting quietly and withdrawing from the world because their minds have failed them.

Facial Cues Arlington CourtIt caused me to consider interacting with him the way I have as an activity professional for decades.  I have always utilized facial expressions and eye contact to connect with residents who are aphasic or non-verbal. I have never hesitated to make silly faces when necessary in order to draw a resident out of his shell. Facial cues are also very beneficial to help a resident who may be agitated. A calm gaze and a warm touch on the shoulder can do wonders for a person who is confused or feels lost. I have even trained my staff at Arlington Court to utilize facial cues and the results have been very effective. Residents who were not participating in group activities now feel safer and often join the group. It is so rewarding to see our residents smiling and sharing more of themselves!

So I utilized these techniques with my uncle.  In no time, he was mirroring my silly faces and laughing that infectious laugh again. We were able to connect as we did when I was child! Just because the words were gone didn’t mean our deep connection was lost. We took strolls outside and when he began to wander, we used eye-contact, gestures and smiles to comfort and redirect him.

We will never get to hear Randy talking about his adventures again. We will never have the chance to hang on his every word.  However, with facial cues, we can continue to share many more years of laughter and joy.