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What to know when talking to someone with Alzheimer’s or dementia

By: REAL Services + Home Comfort Experts

Having a conversation with a loved one who has Alzheimer’s or dementia can sometimes be challenging, but keeping a positive attitude can make a world of difference.

Here are 5 tips that you should keep in mind the next time you talk to a loved one with dementia.

1. Join their reality

While short-term memories are the first to go, older memories (especially emotional memories) often stick around the longest for a person with Alzheimer’s or another form of dementia. Embrace this and reminisce with your loved one, because these conversations are often the most treasurable.

At some point, your loved one may misspeak or misremember something that does not match up with your memory of the same event. It’s a natural urge to want to correct the mistake because most of the time correcting someone will keep them from making the same mistake in the future. That is simply not the case for people with dementia.

“(Correcting them) is like asking someone in a wheelchair to get up and walk. They can’t. They’re doing their best. The person with the diagnosis can’t remember or try to do better next time because they’re having a problem in their brain and it’s not their fault,” Kristina Fuller said. Fuller is the program specialist at Alzheimer’s and Dementia Services of Northern Indiana, a division of REAL Services.

This means that you might have some odd or uncomfortable conversations, where you may be asked the same question or told the same story multiple times. You may have to react to a hallucination that your loved one is experiencing. Joining your loved one’s reality and responding with kindness and curiosity will lead to a more positive interaction while arguing or correcting could make your loved one feel upset. Fuller said that how your loved one feels in that moment will stay with them far longer than their memory of the conversation.

“For people with Alzheimer’s or dementia, the part of the brain that’s affected is not letting them use logic and reasoning anymore. They are living a lot more in their emotions,” Fuller said. So while they can’t remember what just happened, they can remember how they felt in that moment.

Instead, become a problem solver and treat the entire interaction as if it’s an improv sketch. Respond with empathy and understanding. Allow your family member to remember something incorrectly if it makes them happy. It’s more important to turn the confusion into a positive experience than it is to correct your loved one.

2. Keep everything simple, especially decisions

You know how deciding what to watch next on Netflix can sometimes be difficult because there are too many choices? For someone with dementia, that’s how the simplest of decisions can feel.

It’s helpful to give your loved one two options when they cannot make a wrong decision. Instead of giving a loved one an entire menu while out to eat, pick out two items you know they’d enjoy and ask them to choose between them. There’s no wrong choice.

It’s also better to ask questions with yes or no answers instead of open-ended questions, to keep the conversation simple.

“Recognize that communication is two ways and they might not be getting everything that you’re sending them,” Fuller said.

Keep tasks simple by prompting or cueing your loved one for the next step with specific instructions. For example, if a loved one is doing laundry, ask, “Can you put a cap full of the Gain laundry soap in now?”

Keep explanations short and simple and don’t worry about the details.

3. Watch your body language

Because emotions become so prominent and communication can begin to decline, a person with Alzheimer’s or dementia will become more in-tune with your facial expression, body language and tone of voice. Your loved one may be able to pick up on even the slightest changes and guess at your emotions, which can become more important than what you are actually saying.

“If you’ve had a really good day at work, and your spouse has a bad day, you pick up that energy (when you both get home). For a person with Alzheimer’s or dementia, that’s multiplied times 10. They really pick up on those things,” Fuller said.

If you feel that you are getting to a point where you can’t control your body language, excuse yourself to the bathroom or go outside so that you can have the time you need to feel your emotions and compose yourself. Take some deep breaths.

Sometimes body language can also be a useful tool, such as miming an activity like drinking water in order to better explain what you want your loved one to do.

4. Remember that painful moments are not your loved one’s fault — they’re the disease 

When your family member can’t remember a wonderful memory you share or can’t remember who you are, it hurts deeply. When a loved one mistakes you for someone else, especially someone they dislike or don’t want to be around, it’s painful. When they begin to lose their inner filter because the disease has reached a certain part of their brain, it’s unnerving.

It’s difficult, but keep in mind that moments like that are when the disease is taking over. Remember that it’s not your loved one, it’s the disease, Fuller said. Try not to take it personally because a person with dementia can’t help it.

Instead, remember the first tip — to join their reality — and talk to your loved one as if you are the person they think you are. Ask them questions that relate to what they’re saying You could also try asking them to talk about you in a roundabout way. For example, if a loved one thinks you are Sally but you are June, ask, “Have you seen June recently?”

As noted before, it’s most important to keep the conversation positive and to react with kindness and empathy. It will help keep every conversation and experience positive for both you and your loved one.

5. Focus on the good things that remain, instead of what is lost

Instead of trying to correct the things that are wrong or force your loved one to try to remember something they can’t, focus on what is still possible.

Ask about their memories of when they were younger, and have them tell stories about that time. Don’t quiz them or put pressure on them to answer. Share your fond memories that you have with your loved one. Play your loved one music that they listened to growing up and ask them to talk about memories associated with that music. If they bring up a specific topic, ask them to talk more about it.

We all need to feel needed, wanted and useful. People with Alzheimer’s and dementia still want to be helpful and feel like they’re contributing to the world, so give them activities that they can do and that match their abilities. Gentle prompting and cues can be helpful.

“I once knew a client with dementia who would come in and rearrange my office. Then I found out that she used to be an office manager in the 1970s, and I was able to better understand her,” Fuller said. “So I gave her a job in the building and asked her to deliver the mail to all the residents. I thought she might get that seem feeling of contributing that she had from her job. From then on, she looked forward to it every day.”

You can still provide those same experiences that are important to the quality of your loved one’s life while the disease is progressing. Be creative and focus on your loved one’s strengths and interests, and you and your loved one will both be happier.

REAL Services is the only organization helping local Alzheimer’s patients and their families with their day-to-day needs. Do you need help? Call REAL Services at 574-233-8205. REAL Services & Home Comfort Experts are All In For Alzheimer’s.

(Photo Supplied/REAL Services)

(Photo Supplied/Home Comfort Experts)


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