You ask your loved one with dementia a question. Then you wait. And wait. They’re just looking at you.
So you repeat the question. Louder. Slower. Maybe you’re about to move on… and right before you do, they answer.
Careblazer, this is something so many of you tell me about. So why do people with dementia take longer to respond? What is happening in that long silence? Here’s what’s happening in the brain, and the most important thing you can do about it.
What’s Happening in the Brain When Someone Takes a Long Time to Respond
Picture the brain as a giant network of roads and highways. Every word, every thought, every movement travels along them.
When we’re younger, those roads are wide and smooth, with lots of options. The moment someone asks a question, the information races along the fastest route, and we come up with a response almost instantly.
As we get older, the roads start to wear. Maybe they narrow a little. Maybe some of the traffic lights aren’t syncing well. The brain is still working. It just takes longer to receive the message and send one back.
In dementia, some of the roads that used to be open are now completely blocked. Plaques, tangles and cell loss start closing down parts of the brain’s road network.
So say you ask, “Would you like some coffee?” The brain still hears the question. But the usual highway is under construction, so the signal has to find a detour. And that takes longer.
That pause you’re seeing does not necessarily mean confusion or disinterest. It’s their brain taking the time to find a new pathway, a new road, so they can fully understand and then respond.
So when we jump in and repeat the question too soon, or answer it for them, or stop asking questions altogether, we’re shutting down the road while they’re still driving on it.
The Role of Processing Speed
What we’re talking about here is processing speed. And processing speed slows down with age for all of us, even without dementia. Think of it like the speed limit lowering with each decade.
Reaction time, attention and working memory all depend on different brain regions communicating with each other. As those pathways erode, the brain tries to compensate with alternative connections. Detours. That works fine. It just takes longer.
In dementia, where some roads are completely gone, the time it takes to respond can slow down dramatically. From a neuropsychology standpoint, what we’re seeing is reduced cognitive processing speed and disrupted neural connectivity.
This is why your loved one might stare at you blankly for seconds. They’re not ignoring you. It’s just taking time.
How to Help Your Loved One Respond
Ask One Question at a Time
Complex questions and double questions are harder for them to take in and answer. Keep it to one.
Pause. A Lot.
After you ask a question, pause. Pause so much.
It might feel totally uncomfortable to you, because that’s not how we’re used to having conversations. But it might not feel uncomfortable on their end at all. It might actually be welcome. It might be the thing that allows them to truly respond.
Use a Gentle Visual Cue
Show them what you’re asking about. If you’re asking, “Would you like a cup of coffee?” you could have the coffee there as a visual cue too. You’re tapping into as many pathways as you can, and that may help their response come a little quicker.
Resist the Urge to Fill the Silence
Sit in the silence and see if they’re able to respond. Give their brain the space to work.
If you want more on the everyday conversation habits that make things harder, I go through six of them in 6 normal habits that can make dementia behaviors worse.
A Yearly Checkup on Your Medicare Plan
Every year it’s important to do a checkup to make sure the Medicare plan you’re on is still the best one for your healthcare needs.
I love Chapter because if you’re already on the best plan for your needs, they’ll tell you. If you’re not, they’ll show you what other plans might fit you better. One Careblazer emailed me after working with them. They helped her decide to stay with her current Medicare Advantage plan and move her husband to a much better plan.
If you’re on a Medicare plan, or about to be, it’s totally free to call them, and you talk to a real person right away. Visit askchapter.org/careblazers or call Chapter at 504-490-0080 for free, personalized guidance to make sure you’re on the right plan this year. Chapter sponsored the video this post comes from.
*Chapter: Chapter and its affiliates are not connected with or endorsed by any government entity or the federal Medicare program. Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract. Enrollment depends on the plan’s contract renewal. While we have a database of every Medicare plan nationwide and can help you to search among all plans, we have contracts with many but not all plans. As a result, we do not offer every plan available in your area. Currently we represent 50 organizations which offer 18,160 products nationwide. We search and recommend all plans, even those we don’t directly offer. You can contact a licensed Chapter agent to find out the number of products available in your specific area. Please contact Medicare.gov, 1-800-Medicare, or your local State Health Insurance Program (SHIP) to get information on all of your options.
*Average potential savings are based on realized premium, co-pay, and out of pocket savings estimates self-reported by consumers that worked with Chapter Advisory LLC to enroll in a Medicare Supplement, Medicare Advantage, and/or Part D Prescription Drug Plan. The average is limited to consumers that chose to self-report. Savings information is subject to periodic updates and corrections. There is no guarantee of savings and any savings may vary by policy type, state, or other factors.
How Cognitive Reserve Helps Caregivers Too
Careblazer, this part is really important for you.
Our brains are constantly able to change. Yours and mine. Every time we learn something new, solve a problem or have a meaningful conversation, we’re building new neural pathways. New roads.
That helps the brain stay as functional as possible. Even as we lose neurons. Even as our processing speed declines. Even if some of us go on to develop cognitive impairment or dementia. We are laying the roads right now.
That’s why you hear so much about education and working out your brain when it comes to dementia prevention, the same way we focus on working out our bodies. It builds cognitive reserve.
Cognitive reserve means that even though cells in the brain are dying, outwardly we’re doing pretty well. We’re compensating, because we’ve built up so many highways and so many connections that when one closes down, the brain finds another way to get there.
People with higher cognitive reserve, from a lifetime of learning, socializing and staying mentally active, often show fewer symptoms of decline even though the underlying brain damage is there.
So think of every crossword puzzle you do, every book you read, every conversation you have, every new language you try to learn. You’re building your backup bridges. Your backup roads.
I go through more of what research links to lower dementia risk in 14 ways to cut your dementia risk in half.
It’s hard to think about how quickly your loved one’s brain connections are deteriorating. But you are still building your own.
If you’d like to keep learning about moments like these, and talk with other Careblazers about what they’re seeing and how they’re handling it, that’s what the Care Collective is for. There’s live support every week, and a private member area open 24/7, wherever you live. You can learn more here.
