Tips for Alzheimer’s Caregivers: Communicating with Your Loved One
People expect, and even joke about, their parents having a certain amount of age-related forgetfulness, like not remembering where they left the front door key. For some, however, the memory loss worsens until one day, your aging parent can’t figure out how to put the key into the lock. The adult child may at first pass it off as a one-time event or just a problem with Mom or Dad being distracted. No one, child or parent, wants to think about the possibility of being confronted with Alzheimer’s or another form of dementia.
But as numerous adult children, in-laws, nieces and nephews have discovered, the day may come when someone must take charge of an aging parent or relative suffering with dementia, and make the difficult decision that the loved one can no longer live alone. In some cases the parent is moved into the home of the responsible relative, while in other families a relative may spend many hours each day visiting and seeing to the needs and safety of the affected person. One of the basic issues with dementia of any type is communication, and understanding how to respond to the patient’s questions and statements.
When Mom asks day after day, where her husband or even one of her parents is, should her caregiver explain that they are all dead? In her mind, your mother may think she is a young woman, despite the reflection in her mirror. Should you be honest? Mom will no doubt continually ask the whereabouts of her family members, many of whom are deceased. And each time she’s told the unvarnished truth, she’ll grieve anew for the sudden loss of a loved one, as though this is the first time she knew of their passing. And for her, it is the first time she’s learned of it; every time you tell her the truth, she will be hearing it for the first time. Better, then, to bravely lie and tell her that her father’s at work, her sister is baking bread at home, etc. Almost certainly, she’ll be satisfied and will forget about it completely … at least until the next time she thinks of them. This is just one of many opportunities the caretaker will discover that will help to develop their own patience and creativity. When Dad says he was out watering the horses this morning, why argue with him? Why not tell him you saw him out there working hard or ask him how his favorite horse is looking these days?
In some instances, non-caregiving relatives, who have less understanding of the patient’s condition and abilities, may insist upon bringing them “back to reality” by arguing and attempting to make the patient agree with the visitor’s statements. This may be a reflection of the relative’s desire to make the dementia go away and for his mom, dad, uncle or aunt to once again be the person they used to be. “You sold the farm 12 years ago,” they may shout, “and you’re living in your daughter Beth’s house in the suburbs of Chicago. Here, look out of this window and tell me if you see a barn!”
This is useless and cruel, and causes even more confusion in the patient’s mind. Why? Because you rely on your brain and memory without even thinking about it. “Reality” is what your brain tells you is true. If Jim actually drove to work this morning in his new Chevy, he knows it because he remembers doing so. However, if Jim suffers from dementia, his brain may think it remembers driving to work in that Chevy today, even though the car was sold 30 years ago and Jim hasn’t left the house in six months. Jim’s reality is still the same, either way. He knows it happened. Refuting his memory of reality is counterproductive. What does it hurt to play along and tell Jim that you can tell he loves that car? No damage is done, no argument ensues and no negative emotions are aroused. Everybody is happy.
Another problem can occur when the patient loses the ability to process and understand the spoken word. Asking Mom if she wants beans or corn with dinner may be puzzling to her. If so, try holding up the package with a picture of the vegetable or show her the serving platter so she can have a visual of the item in question. The same process is useful when asking what Mom or Dad wants to wear. The words, “blue,” “green,” “sweater,” or “dress” may mean nothing to them now. But when presented with the items themselves, the question becomes clear. The use of hand gestures while speaking can also help. If you make a gesture of driving, while you’re asking if they’d like to go for a ride, the question may be easily understood. Think about the other questions for which an accompanying gesture would help your loved one to understand. You can mimic eating, drinking, walking, even yawning when asking about a nap or bed time.
The main thing is to realize and fully accept the fact that Mom or Dad is no longer the same and will not revert to their former, sharp-minded self, no matter how much you or other family members want it. You can’t “reason” them out of their memories or beliefs about the current situation. Instead, you must be creative and find new ways to show your love and compassion while maintaining their dignity. Think of the brain as a computer. Mom or Dad still has the computer but it now takes longer to shift to a new function. And some information is just hidden from them, buried in the affected brain. If Mom can’t remember your name is Sally and calls you Diane or Judy, just go along with it.
Do whatever it takes to communicate your love and understanding. Your personal information file is still there in Mom’s memory; she just can’t access the file.