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Alzheimer’s As a Second Language

Trying to communicate with a loved one who has Alzheimer’s can be a frustrating, even defeating, experience.  For family members, a simple, well-meaning question — “Mom, what did you have for lunch today?” — can  ultimately sour the conversation and spoil the entire visit.  Sound familiar?

Here is how that scenario frequently plays out: ‘Mom’ will try to remember what she had for lunch, or if she had lunch at all; unable to find the words she thinks her loved one wants to hear, she starts rambling, becomes confused, even angry, and then withdraws from the conversation altogether.

Family members of Garden Place residents often ask how their loved one’s caregivers at Carillon are able to keep the conversation so open, upbeat, and effective. The secret to good communication with a loved one who has Alzheimer’s is no secret at all, says Jennifer Mogle, Garden Place Coordinator at Carillon Assisted Living of Hillsborough.

Here, Mogle shares the communication practices she and her team use with residents and share with families:

Establish and maintain eye contact. This can often improve recognition. For example, use hand gestures to signal your loved one when approaching them from across the room. Think of it as to say, “Hi there, here I come.” This may also help prevent  startling your loved one and adding to any confusion they are already feeling.

Call them by name. Often, we don’t know where our loved ones may be at, on their journey of dementia. Most likely, your loved one is in the ‘primetime’ of their life, meaning that in their mind, they are young adults, with priorities, chores, work, and young children to tend to. (Not unlike ourselves!) Calling your loved one by their name may sound weird, or be very difficult for family members to do.  But try to remember, when you visit, you may often be viewed as just another adult, not their grown child, because in the mind of a resident with Alzheimer’s disease, their children are young. Calling them by name also improves recognition. It allows for your loved one to say, ‘Hey, this person knows me!’

Avoid discussing negative news, negative events, or death. Many families think it is important to reveal to a loved one with Alzheimer’s that a family member has passed on. Your loved one will forget what you’ve just informed them. They will relive this sad information when you visit, time and time again, and you will have to inform them over and over that dear Uncle Ted has passed on. Why subject your loved one to repetitive sadness and grief? You can reminiscence about enduring memories, talk about special holidays spent together, family recipes shared and cooked, and how Uncle Ted always made everyone laugh. You can ‘re-direct’ your loved one by saying, “Ted sure is a good Uncle. What a nice guy!”  Loved ones living with Alzheimer’s cannot live in the present. Informing them Uncle Ted’s funeral is Friday will only upset your loved one, resulting in increased anxiety, restlessness, and/or depression. It’s best just to avoid these topics.

Avoid quizzing your loved one. Quizzing just means asking questions they cannot answer. This can also lead to anxiety and increased confusion. For instance, “What did you have for lunch today?” Your loved one probably doesn’t remember eating, or what was on the menu. Try to put yourself in your loved ones’ shoes. Have you ever had to answer a question you did not know the answer to, in front of your peers? You probably felt embarrassed, right?  Instead, ask yes or no questions, not open-ended questions. Simplify. For instance, take note of the weather. You can say to your loved one, “What a lovely day outside. Would you like to go for a walk?” In the mind of a person with dementia, this is a question I can probably answer. I don’t have to remember anything!

Time your visits. Ask the care staff what is the better time of day for your family member to visit. Maybe they are slow to rise in the morning, or not too alert, so afternoon visits would work better. You want a time of the day when it is beneficial for both you and your loved one to have a pleasant visit. Your loved one may be able to communicate better with you when it is a quieter time of the day, or when they are feeling more energized. This can vary greatly with each person, so asking the caregivers on staff is recommended. We want you to have fulfilling, meaningful visits with your loved ones!



Posted in Alzheimer's and Dementia Care, Perspectives on Alzheimer's, Resources on March 6, 2013

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