Understanding Why Alzheimer's Patients Talk to Themselves

Understanding Why Alzheimer's Patients Talk to Themselves

If your loved one with Alzheimer's disease has started talking to themselves, it can be worrying or confusing. However, this behavior is common as the disease progresses. Here's a closer look at why Alzheimer's patients talk to themselves and tips for responding appropriately.

Alzheimer's Impacts Communication

Alzheimer's disease causes progressive damage to brain cells. As more neurons die, an individual's ability to communicate declines. Talking to oneself often emerges when people with Alzheimer's have difficulty expressing their thoughts and needs to others.

There are a few reasons why self-directed speech develops:

• Struggling to find the right words makes conversing frustrating. Talking to themselves allows patients to speak freely without feeling self-conscious.
• The filters we use to censor inappropriate comments weaken. Patients may voice thoughts aloud that they would usually keep private.
• Short-term memory impairment means patients forget conversations already had. Talking to oneself helps keep a train of thought.
• Unable to follow group conversations, patients provide their own responses instead.
• Loneliness and isolation lead patients to talk just to hear a voice.

In essence, talking to themselves gives patients an outlet to communicate and fills a social void as the disease progresses. While it may look strange to family members, it serves an important purpose for the person with Alzheimer's.

Different Types of Self-Talk

Alzheimer's patients may talk to themselves in different ways:

• Muttering - In a soft voice, patients may murmur repetitive words or phrases under their breath. This is usually an unconscious habit.
• Conversing - Patients may have lengthy conversations as if speaking to someone else. They speak clearly and leave pauses as if listening to replies.
• Talking through tasks - Patients may narrate their actions aloud step-by-step. For example, “Now I’m washing the dishes. Where does this cup go?”
• Repeating questions - If patients can’t remember the answer, they may ask themselves the same question over and over.
• Singing or laughing - Patients may talk to themselves by singing half-remembered songs or laughing at internal jokes.

The self-talk may reflect what patients are thinking and feeling. But sometimes it will be disjointed as language skills deteriorate. Talking to oneself helps patients process information and experiences.

Responding Helpfully

When your loved one talks to themselves, respond with patience and empathy. Here are some tips:

• Don’t interrupt or criticize them for talking to themselves. This can cause embarrassment.
• If they seem distressed, gently ask if they need help or want to talk.
• If their muttering is loud, play music or move to another room if appropriate.
• Engage them in conversation if they seem lonely and wanting social interaction.
• Gently reorient them if they are very repetitive or stuck in a loop.
• Join in singing, laughing, or responding if it helps them feel less isolated.

Keep your tone warm and caring. Avoid lecturing or telling your loved one to be quiet. Validate their feelings and experiences. With empathy and patience, the self-talk won't seem so bothersome.

When to Seek Help

In some cases, talking to oneself can indicate a psychiatrict issue requires attention:

• If new paranoid or threatening self-talk emerges, discuss it with a doctor. This may signal psychosis or delusions requiring medication.
• Talk to a doctor if your loved one has long, angry conversations as if berating themselves. This could reflect depression or anxiety.
• Notify your doctor if repetitive self-talk starts interfering with sleep, eating, or daily function.
• See your doctor if you have safety concerns related to the self-talk, like risky wandering.

A medical evaluation can help determine if medication or other interventions would help manage any psychiatric symptoms exacerbating the self-talk.

Communication Tips

You can also minimize troubling self-talk by optimizing communication:

• Maintain good eye contact and call the person by name to keep their focus on you.
• Break down instructions into clear, simple steps. Don't overload them with complex requests.
• Write down key information like daily schedule reminders.
• Encourage non-verbal cues like pointing or demonstrating to augment understanding.
• Avoid quizzing them or correcting minor errors to reduce frustration.
• Slow down your own speech and allow time for responses.

Meeting communication needs reduces isolation and the urge to talk to oneself. But some ongoing self-talk should be expected as Alzheimer's progresses.

Using Technology

Technology can also help provide stimulation and social connection:

• Play music, audio books, or recordings of family voices to distract from self-talk.
• Watch movies or even play static on the TV when repetitive self-talk emerges.
• Use memory apps or virtual assistant devices to provide reminders and prompts as needed.
• Encourage video calls with friends and loved ones to reduce isolation.
• Consider smart home devices to engage them with news, music, calendars, etc.

Boosting environmental stimulation and communication access meets needs that self-talk tries to fill. Work closely with your doctor to continually evaluate and address problematic behaviors over the course of the disease.

When to Consider Counseling

You may also benefit from counseling to manage the stress of hearing your loved one talk to themselves for hours on end. Caregiver support groups can provide validation and coping strategies.

Talk therapy can help you:

• Process feelings of sadness, frustration, or resentment related to the behavior.
• Learn de-escalation and communication techniques.
• Cope with grief over relationship changes.
• Reduce burnout and stress.

Seeking professional advice helps caregivers be resilient in the face of difficult dementia behaviors. With support, self-talk can be managed for the wellbeing of all.

The Bottom Line

Talking to oneself is a common Alzheimer's symptom as communication skills decline. While it may be challenging, try to respond with patience, empathy and validation. Seek medical advice if concerning new behaviors emerge. With proper help, support, and coping strategies, you and your loved one can manage this challenging symptom.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.