When Words Fade, What Remains?

Sep 14

6 min read

Text by Cady Tay | Photos provided by Anuja Varaprasad

For speech therapist Anuja Varaprasad, dementia is not simply a diagnosis. It is a story of changing relationships, shifting identities, love, loss and finding new ways to connect. In her dance production Unsaid, she brings together her personal experience, her work with older adults and her lifelong passion for Bharatanatyam to explore what remains when words and memories begin to fade.

*Still from Unsaid: Using photographs as a starting point for connection*

Speech therapists are trained to care for persons with dementia by helping them in areas of communication, cognition, feeding, and daily functioning.

For Anuja, understanding dementia has also meant witnessing its impact on families, relationships and identity - first through her grandmother, who lived with Alzheimer’s disease, one of the foremost causes of dementia, and later through her work as a speech therapist with the geriatric population.

It was this intersection of personal and professional experience that gave rise to Unsaid, an independent dance production exploring life with dementia.

The idea first came to her in 2017, while she was doing her clinical rotation in the Geriatric department at Khoo Teck Puat Hospital, two years after her grandmother’s passing.

“Unsaid was born from a collection of personal and professional stories of people living with dementia and the people who love and care for them,” she shared, “and a desire to tell these stories through a medium I am passionate about.”

Having experienced caring for a person with dementia both personally and as a clinician, she found a gap between knowing dementia clinically and understanding what it feels like to live alongside it.

“Clinical language can describe the disease, but it cannot always capture its emotional and human impact,” she said. “The arts have a way of bridging that gap and expressing what can be difficult to articulate in words.”

Seeing the person beyond the diagnosis

Her experience with her grandmother gave her a deeply personal understanding of what it means to watch relationships change and to see family members adapt practically, mentally and emotionally. Her work as a speech therapist subsequently brought her into the lives of many others experiencing similar shifts.

“I realised that the reach of dementia extends far beyond the individual with the diagnosis; it affects entire families and relationships,” she reflected.

This perspective has shaped the way she approaches people living with dementia. Rather than seeing someone simply through the lens of their diagnosis or perceived deficits, she is reminded to see the whole person - their history, identity, relationships and life beyond the clinical presentation. This becomes particularly poignant during home visits.

“When you see someone in their own environment, surrounded by familiar people, photographs and objects, you are reminded of the person beyond the clinical presentation,” she explained. “Their home can hold so much evidence of a life well lived and a person well loved.”

It is this human lens that has found its way into Unsaid. The choreography reflects the relationships and human stories she has encountered through her work, and influenced how she approached the piece.

Beyond words

For Anuja, working with people with dementia has reinforced something more nuanced about communication: even as a person’s linguistic abilities change, their communicative intent and desire for connection may remain.

Rather than focusing solely on what has become difficult, her clinical work has made her more attentive to the ways a person continues to communicate - sometimes through a familiar expression, a change in tone, a gesture, posture or simply the way they respond to another person’s presence.

She has also become increasingly aware of the role of those who know the person best. Caregivers often become attuned to subtle changes that may be difficult for others to recognise, drawing on years of shared experiences and familiarity.

“Working with people with dementia has made me think more deeply about how we communicate and connect when words are no longer as accessible,” she said.

“When we broaden our understanding of what communication means, we begin to see a whole world of ways in which we can continue to connect with someone – through tone of voice, a soothing touch, shared presence, or simply the reassurance of being there for someone.”

For her, this has shifted the focus from what communication has been lost to what connection can still be found.

“Even when words and memories become more difficult, connection does not have to disappear.”

Finding a language through dance

Dance became a natural way to explore this idea of communication beyond words.

Anuja has been learning Bharatanatyam, an Indian classical dance form, since she was seven. While highly technical, she describes it as a form that lends itself beautifully to diverse forms of storytelling.

Dance offered her a way to explore dementia through movement, expression, rhythm and silence - communicating through the body rather than relying solely on language.

“Rather than simply telling an audience about dementia, I wanted to create an experience that might allow them to feel, reflect and perhaps recognise something of their own experiences and relationships within the story,” she explained.

Her professional experiences as a speech therapist have influenced Unsaid not through literal references to clinical practice, but through the way she sees the people at the heart of the story.

Healthcare is deeply emotional work. Meeting patients and families at moments of vulnerability means encountering not only the patient, but also the people around them – family members adapting to changes, navigating uncertainty and making difficult decisions.

She describes caregivers as the “unsung heroes”, providing support and often carrying the responsibility of making difficult decisions along the way.

“While love is present, the burden of care also comes with navigating complex and sometimes conflicting emotions.”

*Unsaid asks: What remains when memories fade?*

Seeing dementia from different perspectives

Unsaid seeks to hold space for these different perspectives.

For the person living with dementia, there may be disorientation, loss of time and space, changes in identity and a sense of being unmoored.

For caregivers, there is the constant work of problem-solving, deciphering moods and emotions, regulating their own responses and supporting someone else - through both the easier and more difficult moments.

Anuja hopes audiences will come away with a greater understanding of this complexity.

“There is no single right way to navigate it,” she said. “There should be no guilt associated with the choices caregivers eventually have to make.”

The production is therefore not simply an exploration of memory loss. It is also an exploration of what happens to relationships when the person we know begins to change, and how families find new ways of relating to one another.

What remains when memories fade?

Perhaps the most powerful question at the heart of Unsaid is also its simplest: if dementia can take away memories and change the way we communicate, what remains?

For Anuja, the answer comes from an idea within Bharatanatyam: sthayi bhava, loosely described as the enduring or primary emotion that resides within the human subconscious. “For me, what remains after memories fade is this sthayi of enduring love – the love that has held relationships together over a lifetime,” she shared.

She recalls caregivers asking questions such as, “How can I do more?” and “How can I make sure they understand me?” For her, the answer lies beneath those questions.

“What remains, for me, is the reason caregivers continue to do so much and give so much: love.”

The process of creating Unsaid has also changed the way she approaches her work. Bringing together years of personal reflection, clinical experience and artistic exploration has left her with an even greater sense of empathy and compassion for everyone involved: the person experiencing dementia, their caregivers and the healthcare workers supporting them.

“It has reinforced for me the heart of clinical work: that it is about doing the best we can for the patient and their families, while trying to understand why they react the way they do and why they ask the questions they do,” she explained. “There is often so much happening beneath the surface that we may not immediately see.”

Ultimately, Unsaid is a reflection on the things that can become difficult to articulate, and on the possibility that communication and connection can endure in forms that do not always require words.

“Communication may no longer be easy or straightforward, but I believe that the love that existed before can endure,” she said. “When memories and words begin to fade, the emotional bonds we have built over a lifetime can remain in ways that are not always easy to explain or put into words.”

Perhaps that is what Unsaid asks us to consider: that even when language changes, there may still be so much left to say - and so many ways left to be heard.