My mother is trying to communicate. I've been with her for almost two hours on this bright spring morning, and during my visit she keeps trying to tell me something. She's unable to find the words.

Often I can guess what she wants to convey, but today I'm coming up empty handed.

Mummy, as we affectionately call her, starts out in a strong, clear voice, "I want to say...." Then the words trail off. Her face darkens, her eyes dart back and forth and her hands nervously rub the arms of her chair. She's attempting to find the words but they elude her. Inside her brain it's a jumble. Mummy has had Alzheimer's for more than five years and speaking has become progressively more difficult.

I offer prompts and rub her back to help her relax.

"Is it about Katie?" Katie is my daughter, and her only grandchild.

Mummy vigorously shakes her head and begins again, "About the...the...the..." Her voice gets small. She shakes her head and shrugs her shoulders. Her eyes look faraway and rummy.

"That's okay, we can talk about it another time," I tell her with a smile. I try to keep my attitude upbeat and encouraging.

In an effort to divert her attention, I bring out a photo album for us to page through.

Yet, Mummy won't be deterred. She attempts once again to share her thoughts, but stalls again. I suggest more prompts. Mummy vigorously shakes her head and we are back where we started.

We're both left feeling frustrated and sad.

Communicating has become progressively more challenging in recent months, and it takes a great deal of effort. Not only can Mummy speak very little, I'm not sure how much she understands. Trying to impart more than the smallest bits of information is often unsuccessful. Frequently, when I'm talking to Mummy she looks at me as though I am speaking a foreign language. From her perspective that is probably what she is hearing. Words and phrases she once understood and took for granted are now indecipherable.

As the disease has progressed, I've learned -- in fact, I am still learning -- how to make accommodations in how I communicate.

For instance, I never speak quickly. I don't use five sentences when one will do. I don't ask complicated questions that Mummy can't possibly decipher.

Instead, I speak clearly and in a straightforward manner. I combine written words along with my spoken words. And, since Mummy has severe hearing loss, even with two hearing aids, I look at her directly when I speak.

I also keep in mind that half of communication doesn't even involve the spoken word. Our facial expressions, gestures, body language and many other nonverbal cues are just as important as what is said. If you have ever played charades, you will know this is true.

Actually, it is pretty amazing how much one can impart without ever saying a word.

And these days, I find it easier and more relaxing to be quiet.

I'm actually okay with quiet. Companionable silence can be comforting.

Mummy and I will never again have any easy back-and-forth conversations. However, we can make the most of what we are still communicate. What we have now are smiles, hugs, back rubs and even a little laughter. It's true we can't always convey exactly what we would like to tell the other person, but we can show how we feel.

At this point, it has to be enough. Somehow it is.

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