Compassionate Communication with the Memory Impaired

4 Do's and Don'ts

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See the world as they see it. Go into their world. Validate it. Uwe Krejci

Communication. It’s important in any relationship, but how does it change when you’re caring for a loved one with Alzheimer’s or another dementia? In the early stages of the disease, it might begin with a story that’s repeated just a little too often or your loved one frequently searching for the right word. As Alzheimer’s progresses and begins to affect reasoning, the old conversation patterns can disappear, and even open-ended questions like what do you want to wear today?

can become surprisingly complex. How do you deal with this new reality? It's starts with compassionate communication.

Knowing that Alzheimer’s is progressive is scary. Knowing that Alzheimer’s robs your loved one of memory loss and reduced capacity to reason is terrifying. Knowing that open-ended questions have become complicated is disheartening. However, with a dash of forgiveness, a measure of patience and the tips below, you can reduce the anxiety and drastically improve your loved one’s (and your) daily life.

  1. DON’T try to reason or argue. Persons with Alzheimer’s may be irrational and easily disoriented.

    DO accept the blame when something’s wrong (even if the problem isn’t your fault) and avoid insistence.

    Example: Your loved one declares you didn’t tell them about an appointment when you arrive to pick them up. Instead of arguing, respond, “I’m sorry. It must have slipped my mind. Is there anything I can do to help you get ready?”
     
  1. DON’T remind people with Alzheimer’s that they forget. Reminders are rarely kind and reinforce how disabled they are.

    DO reassure and distract. 

    Example: Your loved one just ate lunch and is saying he/she is hungry. Instead of reminding them they just ate lunch, offer a snack or set a time to eat in the near future.
     
  1. DON’T confront.

    DO leave the room, if necessary.

    Example: Your loved one gets impatient and yells at you. Instead of yelling back, excuse yourself from the room for a few moments and come back with a smile.
     
  2. DON’T take it personally.

    DO go with the flow and distract.

    Example: Your loved one becomes overly anxious and asks, “Who are you? Where’s my husband?” Rather than take it personally, go with the flow and then distract, “I can see you’re frustrated. He’ll be here for dinner. How about some milk and cookies?  Would you like chocolate chip or oatmeal?”

It’s important to accept that you can’t control memory loss, only your reaction to it. To learn more, check out our free online classes. If you’re unsure about how to handle a situation, call Alzheimer’s Association’s 24/7 Helpline at 800-272-3900. A team of highly trained and knowledgeable staff are available to people with memory loss, caregivers, health care professionals and the public. The nonprofit’s caring professionals can assist with general information —from education on how to understand memory loss to help with specific questions, such as how to get a loved one to take a bath.

The helpline also features personalized and confidential care consultation, referrals to local community programs and a translation service with more than 170 languages. And remember, be kind, don’t remind.

Communication is one of the first casualties of dementia. Because dementia affects memory, people with dementia have difficulty following the thread of a conversation, because they often don’t remember what was said just minutes before. They may think they’re living in a different time or place and speak from this new reality. Follow these tips for success in communicating with a loved one.

Note: Tips included above were provided by Liz Ayres, Alzheimer’s Support Group Leader and former caregiver, copyright 2008.

Deborah O’Connor, Director of Programs and Services at Alzheimer’s Association, Orange County (AAOC), oversees the nonprofits programs which work to educate the community about Alzheimer’s disease. Deborah helps to organize no-cost resources across Orange County for families affected by Alzheimer’s disease.

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