Does one say thank you in the way they know, or do they say it in the way the recipient will understand it?

In the experience with my mother, I have learned that this disease robbed her of her ability to translate what she is trying to say in a way that someone will perceive it.

This has left her to be blunt and straightforward in a last attempt to get others to understand.

Unfortunately, with those not afflicted by this disease, they read into her words and try to decipher what is not there.

And also unfortunately, though her ability to read between the lines is there, her ability to decipher what it means is gone.

I've learned to be very straightforward and say what I mean as best I can, and in return, she says things straightforward as only she can.