February 18, 2011
How can I communicate better with my loved one who has Alzheimer’s?
Learning about Alzheimer’s—how it progresses and how it is managed— is critical to understanding how best to interact and communicate with a person who has Alzheimer’s disease. Along the way, you will learn many tips and strategies for coping with the symptoms of the disease. These symptoms will change as the disease progresses, and you may need to continually adapt your strategies as your loved one’s symptoms and challenges change.
One successful approach to reducing inappropriate behaviors is to communicate in a way your loved one can understand. Consider how your loved one sees the world, and keep that in mind as you spend time with your loved one. It can also help to join in when the person reminisces about happier times from years past, by sharing memories and old photos. Focusing on past times that the person might be able to recall may be less stressful than trying to talk about current or recent events, which may baffle and frustrate your loved one.
Tips for Communicating Better
Here are some other tips that might help you communicate with a person with Alzheimer’s:
- Try to anticipate and address needs or concerns before they become a problem.
- Listen and communicate patiently. Try to reduce the frustrations the person may feel from not being able to communicate effectively.
- Use memory cues—verbal, visual, auditory—to help the person stay on track during conversations or day-to-day tasks. For example, place clothes prominently in plain sight, in the order in which they should be put on, or visually guide the person through getting dressed.
- Write notes to the person to remind him/her to do routine tasks, and provide clear, written directions for accomplishing tasks.
Some specific communication techniques have been shown to be effective in reducing behavior problems and improving day-to-day functioning of people with Alzheimer’s and other dementias:
- Reality: As discussed above, accept your loved one’s version of “reality” so you can avoid frustrations and misunderstandings.
- Validation: Don’t correct or contradict the person’s view of reality; rather, encourage and validate it by really listening and asking questions.
- Redirection: Be creative in redirecting conversation without contradicting or denying the other person’s statements. Take time to share in fond memories or gently remind the person of tasks or appointments.
- Memory cueing: Use words and visuals to cue old or recent memories. For example, play videos of family events; place reminder notes in plain view; color-code or number things in the order they should be done.
Dealing with Aggressive Behavior
In later stages of Alzheimer’s, aggressive or agitated behavior may become common, which can make it more difficult to care for a loved one at home. Agitated behavior is considered a symptom of the disease itself. But some experts believe that such behavior, in part, may be a Alzheimer’s affected person’s reaction to the behavior of people around them. For example, talking too loudly or too fast, or contradicting your loved one’s beliefs about what is real, might cause agitation. A growing body of research is showing how these techniques can help reduce disruptive behaviors in people who have Alzheimer’s.
If your loved one is agitated or disruptive, examine how your own actions may be affecting that person’s behavior. Try to determine if something you have done (or have not done) might be triggering an agitated response, and keep that in mind change that behavior when the situation arises again.
One of the most common sources of disruptive behavior occurs when a person with Alzheimer’s feels his or her personal space has been invaded—often, while dressing, bathing or visiting the doctor’s office for an appointment. Also, the traditions surrounding important holidays or large crowds may trigger agitation. It’s important to understand that someone with Alzheimer’s is more likely to misinterpret certain actions and respond aggressively. Aggression can also arise as a result of a physical illness, such as constipation, infection, pain, depression or anxiety, and a lack of sleep.
Fortunately, steps can be taken to help prevent and treat aggression in a loved one with Alzheimer’s.
It’s important that a doctor evaluate the person with Alzheimer’s to identify any physical complaints that may be contributing to the problem. The caregiver should also keep a written journal of events that lead to aggressive behavior. Tell the doctor what happened just before an outburst, how the person acted, and what happened afterward. The journal should also list how often aggressive behaviors occur and what, if anything, reduces or defuses the outbursts.
Identifying patterns that set off aggressive behavior can help to avoid outbursts in the future. For example, if a loved one becomes combative when trying to decide what to eat or wear, you can limit the choices available. For example, rather than asking, “What would you like for lunch?”, prepare a sandwich. Or, instead of saying, “Get dressed,” say “Put these pants on.”
Maintaining a regular routine may also help to avoid conflicts. Playing music that the person with Alzheimer’s finds soothing during problem times such as bathing may also help. Regular and gentle exercise on days when the person with Alzheimer’s must visit the doctor, for example, may also help to reduce aggressive behavior. Your doctor may also prescribe medications to reduce agitation.
Despite your best efforts, outbursts will still occur. Try your best to remain calm and stop whatever it is that you are trying to get your loved one to do. Do not argue or punish the person. He or she may not be able to remember the incident or be able to learn from it because of the nature of Alzheimer’s.
If an outburst occurs, talk to the person in a calm and non-threatening manner. Keep your voice low and soothing. If the TV or radio is on, turn it down or off. If someone is upset because they can’t find their wallet, for example, spend a few minutes with them helping to look for it. Or, switch to a new activity, like sitting in a rocking chair.
Do you have a question you would like to ask the experts at the Fisher Center for Alzheimer’s Research Foundation? If so, please call 1-800-ALZINFO, visit ALZinfo.org or send surface mail to Fisher Center for Alzheimer’s Research Foundation, West 46th Street & 12th Avenue, New York, NY 10036, or e-mail firstname.lastname@example.org.
Source: www.ALZinfo.org. Preserving Your Memory: The Magazine of Health and Hope; Winter 2009.