Dimmi Tutto

When living in Northern Italy this past fall, I learned a new phrase I hadn’t remembered hearing on previous trips: dimmi tutto. It translates to “tell me everything,” but apparently it isn’t meant to be taken literally. 😐 I quickly realized this after my first conversation with my future boss, who’d really only wanted to know why I’d been stalking her for two weeks (does no one in Italy answer emails?!). In other words, she was prompting me to introduce myself and explain why I had reached out. “Umm.. mi chiamo Christina Candido.. Ho 26 anni..” I’m cracking up just thinking of how awkward I was!

While dimmi tutto doesn’t require a detailed response, Italians do love to chat about anything and everything. One of the reasons I’m so drawn to the elderly is that I, too, am super chatty; I could sit with them for hours and hear their stories. Eventually, though, many of my loves with Alzheimer’s disease lose the ability to communicate verbally. For some, the process is gradual and progressive; aphasia can accompany dementia and involves confusing language impairments. While one’s intelligence remains unaffected, they may no longer be capable of finding words, reading, writing, or even of speaking aloud.

So what happens then? What happens when a nonna can’t tell me to eat another plate of food? Or when a nonno can’t articulate which button down he prefers with that hat? More importantly, what if they’re in pain? With language deteriorated and perception clouded, things become excruciatingly (no pun intended) complex. According to Teepa Snow, renowned occupational therapist and dementia specialist, those suffering from the disease can no longer identify, describe, or isolate where the distress is coming from because wiring is missing in their brains. Once unable to convey distress verbally (effectively, at least), nonverbal cues become extremely important. Listening and observing are key components to recognizing a need for help:

“Early in the disease, the person probably can communicate feelings and problems in words; later, his or her behavior articulates what words cannot. If he is yelling or striking out, this can signify that he is in pain or has an infection and needs medical attention. Wandering can suggest boredom. Tears can suggest loneliness and the need for more activity and interaction with other people. When you stop, look, and listen, the person’s behaviors communicate many things.” – A Dignified Life

When deciphering messages from nonnos and nonnas, be patient and empathetic. Really listen to them and focus on what they’re longing to tell you, as changes in “normal” behaviors or appearances can be indicative of something detrimental going on beneath the surface. Assume that agitation is a symptom of something significant, as are restlessness and anxiety. Be suspicious when your love doesn’t want to get out of bed or participate in daily activities. If it seems like something’s up, get it checked out and explain the situation. In this case, take “dimmi tutto” literally.

*The following link is a clip of Teepa offering examples of nonverbal signs of pain. She offers tips for deciphering what is said from what is actually meant when a loved one has a difficult time communicating needs. https://www.youtube.com/watch?v=9kSjHtHSJCw



Un po’ di nebbia a Venezia ❤

At my new job, we have a “lending library” of activities caregivers can use with clients that are so fun and that remind me of those I’ve used in the past. For instance, a popular memory game we’d play in Italy involved naming a fruit, a city, and an object for (almost) every letter of the alphabet. I especially enjoyed playing with one of my favorite nonnos, who was always happy, playful, and excited to participate. We would laugh so hard! There were numerous times, however, when he’d be stumped (and understandably so! Can you name a fruit that starts with z?!) When my love was unsure of an answer, he’d respond with “nebbia” to let me know he wanted a pass. Nebbia actually translates to “fog;” his mind was cloudy. His thoughts were also foggy when asked the names of his grandchildren and, occasionally, even his own kids.

What a powerful analogy. I’ve worn contacts since I was 12 years old and I am frighteningly helpless without them: I have no idea who I’m looking at, driving is a form of Russian Roulette, and I’m actually afraid to be up and moving around because I have such a hard time seeing that navigating even familiar surroundings is dangerous. Worse yet is that I know it shows… it’s mortifying! That being said, I can’t imagine my mind being foggy on top of my vision. If I can respond “fog” to an ophthalmologist and feel ashamed, I cannot fathom admitting I’m unclear about my brothers’ names.

A great friend of mine recently shared this video with me: http://youtu.be/QEmBmokHU3Q. It demonstrates the Virtual Dementia Tour, which is a method of instilling awareness and increasing understanding of the effects of dementia. The VDT uses sensory tools to mimic the fog that is created by Alzheimer’s. I am dying to try it, especially after seeing clips like the one above. I’ll be sure to wear my strongest contacts when I finally do :-O