By Ann Carter, regional director, Alzheimer’s Association of Colorado Southern Region
Communicating with a loved one in the various stages of Alzheimer’s disease or other types of dementia can be challenging and frustrating for both sides. I can’t take credit for many of the following suggestions. Rather this is information I have gleaned from industry experts, colleagues from the Alzheimer’s Association, and watching my own mother struggle with the caregiving of my grandmother who we realize only now had Alzheimer’s disease. Regardless though, I hope this summary can provide some tips that might help make days a little better for those traveling this journey.
Don’t correct or try to teach
In the early stages of Alzheimer’s, people may “lose” the correct words for something and use strange words you don’t understand. The loved one knows what he or she is trying to convey and can’t understand why you don’t get it. On the other end, the caregiver may be hearing strange words or requests that seem nonsensical.
For example, one woman kept asking for a “new pert,” and became increasingly agitated that her caregiver didn’t understand her.
When you can’t understand, ask questions. Ask what a pert does or where you can find one. A series of questions about a strange word may help you decipher what the person is trying to say. And once you figure out that a “new pert” is actually a clean shirt, don’t correct or try to teach the word when that part of the language may be gone.
Communicate with care
As dementia evolves, communications can become even more challenging. The approach I see as most effective is communicating with the person from the front and at their level. Sit across from them if they are sitting and stand across from them if they are standing. Peripheral vision will decline, so facing the person straight on is important.
Other important strategies including calling the person by the name they prefer and making eye contact. Similarly, pay attention to your tone of voice. Persons with Alzheimer’s quickly pick up on your frustration, and it adds to theirs.
Take your time and don’t speak in complex sentences. For example, if I say ‘I’m making your lunch now and I’ll be back after work to fix dinner at five o’clock,’ that’s more than they can comprehend. Just say ‘I’m making lunch.’
Choices can also be frustrating and confusing. Instead of asking whether your mom wants to wear her red sweater or the brown coat with the scarf, just get the red sweater.
When visiting someone with Alzheimer’s, always introduce yourself, even if the person is your spouse or parent. Don’t try to make them guess or “test” their memory.
That same person may recognize you now and 10 minutes later not know who you are. If it is apparent that you are recognized, say whatever it is you have to say immediately because the “connection” may not last.
Don’t try to reason
Another element of Alzheimer’s is that the individual may make outrageous claims; e.g., people are stealing from them, or that their spouse is having an affair. There is nothing to be gained by attempting to reason with this person. A better approach is to apologize and validate their feelings, reassure by promising not to do whatever it is again, and then re-direct to another conversation or an activity they like. You might be able to distract them with something as simple as a mention of the weather or an offer of a cup of tea.
“Therapeutic or compassionate fibbing” can often come in handy. If your loved one with Alzheimer’s asks about a baby that has long since grown or keeps wanting to see a deceased spouse or parent, it’s best to just tell them the kindest thing you can think of. Say that the person is working or they’re on vacation, and that they’ll return later. Again, if the fib is kinder than the truth, use the fib; this is not a ‘teaching moment.’
The person with Alzheimer’s may also ask to go “home” when they already are home. The confusion arises because the person may be thinking of home, not so much as a building, but as a place where they felt safe or a time when the world made more sense. At that point, the best the caregiver can do is reassure the person that you will keep them safe and take them “home soon.”
Be kind to yourself
Caring for a loved one with Alzheimer’s can be extremely stressful, and leave the caregiver feeling very unappreciated. Therefore, one of the most important things you can do is to be kind to yourself – giving yourself credit every day for the good work you are doing.
Here is an approach that was shared with me that some might find helpful. Each night and before you go to sleep, write down three things that upset you that day, and then toss them in the trash. Then write down three things for which you are thankful, and keep those close.
Every day is a redo.
The Alzheimer’s Association offers a broad range of programs and services for caregivers, all at no charge to the families. To learn about educational classes, click here. To learn about support groups, click here. Or to contact the Alzheimer’s Association of Colorado’s confidential 24/7 Helpline, call 800-272-3900.