Communicating with someone who has Alzheimer’s

August 10, 2010

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. In the process you will learn many tips and strategies for coping with the cognitive and behavioral symptoms of the disease. These symptoms will change as the disease progresses, and you may need to continually adapt strategies in accordance with your loved one’s level of function and symptomatic behaviors.

One successful approach to reducing inappropriate behaviors is to communicate within the affected person’s frame of reference. Consider how your loved one sees the world and interact with respect for that “reality.” It can also be helpful to engage the person in reminiscing about happier times by sharing memories and old photos; interactions that are focused on past times that the person might be able to recall may be less stressful than trying to communicate about current or recent events, which may not be accessible to the person.

What are some tips for communicating better?

Here are some other tips that might be useful in interacting with a person with Alzheimer’s:

  • Try to anticipate and address needs or concerns proactively.
  • 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 during dressing.
  • During the early stages of the disease, write notes to the person to remind him/her to do routine tasks, and provide clear, written directions for accomplishing tasks.

What communication techniques work best?

A number of specific communication techniques have been shown to be effective in reducing problematic behaviors and improving day-to-day functioning of people with Alzheimer’s and other dementias:

  • Reality therapy: Interact with the afflicted person within his or her own frame of reference for the world, even if it has little to do with reality.
  • Validation therapy: 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 person’s statements. Use any opportunity possible to try to elicit fond memories or remind the person of tasks or appointments.
  • Memory cueing: Use words and visuals to cue old or recent memories. For example, play videotapes of family events; place reminder notes in plain view; color code or number things in the order they should be done.

How do I deal with aggressive behavior?

In later stages of Alzheimer’s, aggressive or agitated behaviors may become common and may make it increasingly difficult to care for a loved one at home. Though generally viewed as symptoms of the disease itself, some experts believe that such behaviors may in part be reactions to the actions of people around them. For example, talking too loudly or too fast or contradicting the afflicted person’s perceived reality might cause agitation. A growing body of research is showing how certain techniques for communicating and interacting with a person who has Alzheimer’s can help reduce disruptive behaviors.

If your loved one is agitated or disruptive, examine how your own actions may be influencing that person’s behavior. Try to determine if something you have done (or have not done) might be triggering an agitated response and change that behavior in subsequent situations. Certain social situations, such as a holiday reunion of family with noise, kids, pets, etc., may trigger agitation. In such instances, it may be helpful to remove the person to a quiet area away from large groups of people until they calm down.


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