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Talking to a Loved One With Alzheimer’s

Talking to a loved one with Alzheimer’s disease in the right way can improve overall well-being for caregivers as well as their partners and help to ease the caregiving burden. Those are the findings of a study from Florida Atlantic University’s College of Nursing that looked at a program designed to aid communication skills in caregivers and improve the way those with dementia interact with loved ones.

For the study, researchers recruited 15 married couples, one of whom was in the moderate stages of dementia. Over the next 10 weeks, they completed weekly exercises at home using an instruction booklet that taught communication skills. Researchers also met weekly with the caregivers and those with dementia and reviewed videos of the couples conversing.

“Caregivers are not experts in communicating with people with dementia,” said Christine L. Williams, the study leader and a professor and director of the Ph.D. in Nursing Program in at the school. “Sometimes they choose strategies they think are helpful but may be ineffective. Also, they often give up communicating with their less verbal partners because benefits are not as obvious.”

For example, someone with Alzheimer’s might perceive questions that require memory skills as a threat, which can contribute to anxiety and impede a conversation. Impaired communication in turn leads to misunderstandings, conflict, isolation and loss of intimacy.

So caregivers were taught to avoid criticizing or quizzing their partner’s memory with questions like “Do you remember our wedding day?” or “Who is that person next to you in the picture?” At the end of 10 weeks, the caregivers tended to be more engaged with their partners. They were also less likely to say things that might shut down conversations.

Those with dementia were likewise encouraged to make communication more sociable, such as taking care to make eye contact when talking or following up on ongoing conversations. Researchers likewise encouraged their efforts to verbally express their thoughts, feelings, preferences and needs.

Benefits likewise emerged in this group. At the end of the study period, those with dementia tended to be more interested and engaged, and were more likely to maintain eye contact, respond to questions, stay on topic and even joke with and tease their partners. The findings were published in the International Journal of Geriatric Psychiatry.

The study stems from a program called CARE, or Caring About Relationships and Emotions, that was developed by Dr. Williams. The goal is to teach caregivers constructive ways to talk with a loved one with Alzheimer’s, who can no longer interact in the ways they did before the memory and thinking deficits of dementia took hold.

“By teaching caregivers about their partners’ ongoing needs for closeness, comfort, inclusion, love and respect, they can make a difference in how they perceive their spouses and how facilitative communication, both verbal and nonverbal, can contribute to their well-being,” Dr. Williams said.

“While marital counseling is available, it’s very different when you have one partner who is losing their ability to communicate,” Dr. Williams added. “We don’t teach families how to communicate with someone with dementia, but it is desperately needed.”

By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Christine L. Williams, David Newman, Lena Marmstål Hammar: “Preliminary study of a communication intervention for family caregivers and spouses with dementia.” International Journal of Geriatric Psychiatry, Feb. 2018

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