Trilingual, in hospital, confused

[WartOrNot]

My elderly dm has just been admitted to hospital with infection and injury. She is an intelligent woman, fluent in three languages including English (I only speak two of them because our family doesn't use the third any more), but with the beginnings of dementia. She is very distressed at being away from her husband.

When staff talk to her in English, mum is coherent and co-operative, but when she talks to me in our mother-tongue she is completely disconnected from reality. Irrational fears, describes things that could not have happened. I understand that this is part of the infection and of the dementia.

I thought that speaking our mother-tongue would be reassuring, but I really don't know. Would it be better for mum if I only spoke English with her right now? Would it calm her? OTOH the more we talked the more connected she became with reality, and she seemed to feel safer. I really don't know how to help her.

I'd definitely say that talking in her first language is an excellent idea, and you should also keep the doctors and nurses updated on how she sounds in that language.

(I'm a speech and language therapist working with older people)

Do whatever makes her feel happy and safe

Given the massive difference between her demeanour and conversation in each language, I'm not convinced that mum does feel safer in mother-tongue. Unless she is masking in English? Is that even possible?

I have explained to the nursing staff, though not told them exactly ahead Mum is saying.

I'm actually talking in mum's second language. Like me, her first language was swiftly replaced by the local language when she started nursery, and her mother-tongue became the family language. As elders passed way, the first language dropped out of use entirely.

I sincerely hope mum doesn't revert to her actual mother-tongue, as her mum did, because then I would struggle to communicate effectively with her.

Loosing second/third language is a known phenomenon with Alzheimer’s. My DM was a teacher, who picked up, and loved learning new languages. She worked in inner London and wherever the flashpoint in the world was, she learnt the language to help the kids (refugees) in her class - and their parents. Arabic (Somali and various other variants), Cantonese, Mandarin, various African dialects plus 8 European languages. As dementia progressed, she lost them (pretty much) in the order she acquired them.

it is usual for languages to go in this order and does cause problems for those who do not have English as their first language.

I had a conversation with a specialist dementia nurse who, when we were discussing DM, said it was particularly important to take medication to slow the progress of people who didn’t have English as a first language.

If you knew what language she thought in would that help ?

I've always thought mum thinks in our family language. We've always slipped in and out of it, sometimes within the same sentence. We weren't always aware which language we were using, until one of us got stuck on a word, or the English-speakers looked confused.

Mum asked me to speak in English at one point today. It's confusing.

It sounds as if you are used to speaking a mix of languages normally . Perhaps carry on with doing that and see if it helps .