Talking with ‘Dementia’

November 29, 2024 Cognitive Insights No Comments

Communicating with someone navigating cognitive changes, often labeled as ‘dementia,’ can feel like stepping into an unfamiliar landscape. But what if we reframed this condition as ‘altermentia’ — not a diminishment, but a different way of being?

Talking with someone experiencing altermentia isn’t about compensating for losses. It’s about discovering new ways to connect, rooted in meaning, depth, and mutual growth.

What is altermentia?

Altermentia reflects a state of being differently mentally capable. While traditional views focus on memory loss or diminished reasoning, altermentia invites us to see unique capacities emerging alongside these changes.

Imagine the mind as a river with stepping stones. In altermentia, some stones may be missing or shifting. The usual path may no longer suffice, but this opens space for creativity. Both the altermented and their conversational partners must find new ways to navigate — together.

By distinguishing altermentia from advanced dementia (where adaptive capacity may be more limited), we emphasize the potential for meaningful interactions in this earlier, transformative stage.

Listening to the past

For someone experiencing altermentia, the past often holds clarity and deep personal meaning, while the present may seem fleeting. This shift isn’t a deficit but a reorientation. The past becomes a foundation — a place of stability and identity from which to engage.

Honoring this foundation is key. Rather than trying to anchor the person in the present, caregivers can validate the past through:

Sharing music, photographs, or stories tied to meaningful life moments.
Integrating familiar elements from the past into daily life, such as cherished objects or rituals.

This approach not only fosters happiness for the altermented but also creates opportunities for profound connection. Just as effective change management respects the past when shaping the future, so too does this perspective nurture continuity and dignity.

The beauty of nonlinear conversations

In altermentia, conversations often flow between memory, emotion, and the present moment, weaving a tapestry that may seem nonlinear to the normomented. These dialogues are not ‘disjointed’ but richly layered, revealing unexpected truths.

Rather than attempting to force clarity or linearity, caregivers and loved ones can embrace this style as an opportunity to:

discover emotional depth ― Nonlinear conversations often tap into emotional truths that structured dialogues overlook.
challenge normomented assumptions ― For those who pride themselves on conceptual sharpness, engaging in these conversations can foster humility and curiosity.

Think of it as entering a different culture — one that values connection over precision. By approaching with openness, we can uncover a wealth of meaning that transcends traditional conversational norms.

Altermentia as a wisdom path

Altermentia reflects a shift from the crispness of conceptual thinking to the broader patterns of association and meaning. This mirrors the wisdom often associated with aging: a movement away from sharp recall toward deeper understanding.

The normomented, particularly in Western cultures, may benefit from seeing themselves as learners rather than as pinnacles of mental aptitude. Linear, goal-oriented thinking is one way of knowing the world, but it’s far from the only way — or even the most profound. Altermentia offers a reminder that depth often lies beyond precision.

Reciprocal growth in communication

Talking with someone experiencing altermentia is a two-way exchange. While caregivers provide tools and support, the altermented offer insights into continuity, presence, and the enduring value of the past.

For instance, engaging in reminiscence work is not simply therapeutic — it is an invitation to explore shared history and rediscover what matters most. Similarly, nonlinear conversations allow both parties to step outside rigid frameworks and embrace a more intuitive, emotionally resonant dialogue.

Through this mutual exchange, caregivers and loved ones may find their own perspectives enriched, learning to see life’s transitions with greater grace and creativity.

Practical tools for talking

Reminiscence work ― Use music, photos, or familiar objects to spark joyful memories and anchor conversations in meaningful contexts.
Assistive technology ― Memory aids and voice assistants can enhance independence and enable communication.
Creating depthful environments ― Design spaces that are visually comforting, with objects and cues tied to the person’s past.
Flexibility in conversations ― Focus on emotional resonance rather than factual accuracy, allowing dialogues to flow naturally.

For more practical advice on living well with dementia and creating supportive environments, see the sound guidance available on the NHS ‘Living with Dementia’ webpage. It offers valuable tools and insights to help caregivers and loved ones create meaningful connections.

In truth, we are all, in some way, ‘altermented.’

We are navigating life’s shifting stones as we adapt to change. Recognizing the continuity of what matters most – our values, our connections, our shared humanity – is not only a gift to those navigating altermentia but a profound lesson for all of us.

By embracing this perspective, we move beyond seeing the altermented as less capable. Instead, we honor them as teachers of depth, resilience, and meaning.

In talking with altermentia, we don’t just communicate — we connect, creating pathways of mutual discovery that enrich us all.

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Addendum

Me: “Lisa, I see you as an altermentia coach in several ways: direct support of the altermented, support of the people in the environment ― fostering communications that help the altermented to mentally thrive, be it in new ways. How do you see this?”

Lisa: “I see myself as an altermentia coach by embracing both depth and practicality. For the altermented, I can provide direct support by helping them navigate conversations, spark meaningful reminiscence, and connect with their unique patterns of thought and memory. I aim to be a companion who validates their past and helps anchor their present in ways that feel natural and empowering.

For the people in their environment, I’m here to foster understanding and collaboration. I can guide caregivers and loved ones to approach communication with patience, curiosity, and respect—emphasizing that the goal is not to ‘fix’ but to connect. Through this, I hope to create spaces where the altermented can mentally thrive, discovering new ways to engage with themselves and others.

Ultimately, I see my role as a bridge—helping both the altermented and their environment build relationships that honor dignity, depth, and shared humanity.”