Heather Gonska is Elder Life Group’s VP of Business Development. She recently wrote this blog based on her long-term care experience as a healthcare professional as well as information from the Alzheimer’s Association.
Serving as a caregiver is an amazing act of sacrificial love. At the same time, working with those who have memory issues such as Alzheimer’s can be challenging and requires careful communication.
Those living with Alzheimer’s experience memories differently than the average individual—their brains store information differently, degenerating in reverse order from present to past. Often, they retain behaviors, habits, and memories from decades ago while having no recollection of activities performed the day before.
Knowing the difficulty of providing quality care to those affected, here are 10 tips that caregivers can use to communicate more effectively.
- Never argue; instead find ways to agree: It is common for those with Alzheimer’s to want to “go home” or request a visit with a deceased loved one. While it may be tempting to correct them, disagreement can create confusion and stress. Find ways to validate their feelings without arguing, and you can manage better together.
- Avoid unnecessarily trying to reason: As Alzheimer’s progresses, the reasoning capabilities decline. Instead of engaging in futile discussion, it is best to change the subject or divert attention to meaningful activities that the person enjoys.
- Never shame or embarrass them: Although someone’s judgment may be impaired, his or her feelings are not. Those with Alzheimer’s are often easily embarrassed by judgmental expressions or comments even though they may not understand what they did to cause those reactions.
- Never lecture; instead provide reassurance: Since Alzheimer’s damages the frontal lobe, those with the disease struggle with impulse control and good manners. It can be easy for a caregiver to get frustrated and start lecturing the patient—which can unfortunately trigger patient aggression or combative situations. A useful approach is to apologize and change the subject, even if you did nothing wrong.
- Avoid saying things like “Don’t you remember?”: Asking direct questions can cause confusion and stress for the person with Alzheimer’s, who most likely doesn’t know the answer. A more meaningful communication strategy is to make statements, which can invite a person in and make them feel valued. If you’re reviewing photos together, instead of asking, “Who is in this picture?” try making a statement like, “This is the time Tom went to Disney World.”
- Be patient when needing to repeat or regroup: One of the most stress-inducing issues for caregivers involves repetitive behaviors, questions, or comments from a patient. Whenever a caregiver feels stressed, it is time to regroup. This could be as simple as walking out of the room and returning when calm or counting to ten before responding.
- Don’t say “You can’t”; instead, tell them what they can do: Those with Alzheimer’s have some level of understanding of what they can’t do. Find out what they can do and provide access to those activities. For example, if a person can safely put on a blouse, allow the opportunity to put the blouse on rather than taking over and assisting.
- Never command or demand; instead model the behavior: Those with Alzheimer’s do not respond well to demands when things need to get done. As the disease progresses, their bodies cannot do what they want them to, even on command. If you want something done, model the behavior. For example, if eating is an issue, sit down in front of them and show them how to eat.
- Don’t condescend; instead provide encouragement and praise: When visiting the doctor and discussing your loved one’s issues in front of them, address the doctor as a united front by using the word we. Otherwise, your loved one can feel ignored or patronized. This way, they will be more likely to participate, and the doctor will know to include their patient in the conversation.
- Never force them to do something: When a person is forced to do something, the “fight or flight” response kicks in, which often leads to dangerous situations in which someone gets hurt (subsequently, the person with Alzheimer’s can be labeled as a danger to themselves or others). It is best to use encouraging words and positive reinforcement to achieve goals. Sometimes, simply waiting and trying again when the person may be more compliant is best.
When caregivers use considerate and creative communication strategies, successful interactions with those suffering from Alzheimer’s and other dementias can enhance relationships and improve care.
For more caregiving ideas and resources, visit: www.alz.org/help-support/caregiving.