The Handoff
Her Words Are Not Coming: How to Tell the Handoff Has Lost Her Voice | Caring for My Wife
When she cannot say what she needs, the next person is guessing, so this guide shows how to test that gap and write her signals on the sheet.
The problem is usually not that she has nothing to say. The words do not come out the way they used to, or she cannot choose the right one. Many people who have had a stroke or who live with dementia lose some ability to find or say words, and the change can be slow enough that you stop noticing it. The sitter often notices it in the first hour.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
How to tell you have the problem
Look for these in a normal day:
She points at the cup and you bring the bowl. She uses the same word for the bathroom and for the television. She nods yes when she means no, and you cannot tell which until later. She starts a sentence, stops, and goes quiet. The sitter asks you what she wants while you are in the room only to watch.
Run a simple test. Pick three things she needs most, usually the bathroom, pain or discomfort, and thirst. Ask the sitter, or a second person, to read her signals for one afternoon while you are out of sight. Count how many of the three they get right without you. If the answer is fewer than three, the handoff has the problem.
Build the signals she already has
Do not invent a new language. Watch what she already does: a nod, two taps on the chair arm, a turn of her head toward the door, a frown at the window. Write each one on the day sheet with what it means and what the person should do next. Keep the list short. Five clear signals work better than twenty that nobody remembers.
Example line for the sheet: taps the arm twice means the bathroom now; turns to the door and frowns means she wants you.
Ask for a speech review
Her doctor can refer her to a speech-language pathologist, who can assess how she finds and says words and suggest tools such as a picture card or a yes and no board. Bring your three-signal list and your test notes. Ask which tool they recommend for her, how to use it at 2 a.m., and when to recheck. If the team agrees to a referral, ask for it in writing.
When it is not a day sheet problem
If her speech changes suddenly, or her face, arm, or words change quickly, do not wait for the sheet or for the next visit. Call emergency services right away.