Disease Care

Alzheimer's Disease : Managing the Disease

One of the biggest obstacles family members and other caregivers experience is communicating effectively with a person who has Alzheimer's. Here are some helpful tips:

Keep it simple

Say the person's name and identify yourself to him or her.
Establish and maintain eye contact.
State your message using simple words. Avoid being lengthy.

Keep it positive (avoid the negative)

Negative: "Don't put your hand in the gravy."
Positive: "Please put your hands in your lap." (use gestures)

Avoid questions

"We are having macaroni for lunch today," versus, "What would you like for lunch today?" There are exceptions. Remember life is about daily change. Be flexible. If you need to ask a question, limit the choices given. "Would you like chicken or macaroni today?"

Go one step at a time

Break tasks into simple steps:

"Pick up the comb."
"Comb your hair."
"Pick up your toothbrush."
"Put the toothbrush on your teeth."
"Move the toothbrush."

Speak to the person as an adult

Be aware of your tone of voice. Remember to preserve the person's dignity at all times. It is common to use the word "we" as in "Don't we look pretty today?" Instead, say, "You look very nice today," which is more respectful.

Use non-verbal communication

Tone of voice, facial expressions, touch and gestures are effective and important parts of communicating with your loved one.

Tone of voice

Listen to your own tone of voice; it speaks volumes. The person with memory loss maintains the ability to understand tone of voice, even after the ability to understand words has been lost. Listen to the person's tone of voice. It will reveal his/her message more so than words.

Facial expression

A person with Alzheimer's is able to read your facial expressions even though you may not even be aware of them. When we speak to someone, we usually look them in the eye to assess their feelings or their intentions. The entire face -- eyes, forehead, nose, eyebrows and cheeks-communicate a vast range of emotions to others.

Touch

It is important to offer reassurance to a person with Alzheimer's. Hugs work wonders. Touch provides comfort and pleasure. Touch the person's arm or shoulder, hold hands, pat his or her back. Don't move the person from a wheelchair without letting him or her know first. With a gentle touch and reminder, say, "I need to move you to the table now."

Gestures

We use gestures daily to communicate our needs -- hand gestures to describe how large something is, pointing in the correct direction to guide someone, waving to say "hello." Using simple gestures is very helpful to people with Alzheimer's. However, avoid gestures that could be misinterpreted as being threatening to your loved one.

Speak slowly

It takes longer for a person with memory loss to process what we have said. By speaking calmly and slowly, you have a much greater chance of being understood.

Be aware of hearing or vision problems

Older people suffer with these losses. Be patient and understanding. Imagine going through life daily with cloudy lenses on your glasses. This is literally how some elders see.

Smile and the world smiles with you

Look for the good and the positive in people and in life. Laughter is the best medicine, so use your sense of humor. Be sensitive not to laugh at your loved one, but at the situation.

Put logic and reason "on the shelf"

Confrontation with your loved one will increase his or her agitation and anxiety. Instead of saying, "You know you're not supposed to wear that bra outside of your dress," try: "Let me help you with this."

Forget the phrase "Don't you remember?"

Erase that phrase from your vocabulary. "This is your daughter, Susan." versus "Don't you remember your daughter, Susan?" This approach helps the person "save face."

Always validate their feelings

Even if the content of what your loved one is saying is "not real," the feelings are always real. An example of validating is, "I know how upset you must feel to think I'd steal your purse."

Truthfulness may not always be the kindest response

As your loved one loses memories, he or she can no longer enter into your reality. Confronting that person with a reality, such as the death of a loved one, may actually be cruel. Forcing a person with a severe memory problem to hear a "truth" will cause emotional pain. It is better to validate the feelings the person is expressing rather than make him or her face a reality that is totally gone from memory.

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