Quick summary
It's so easy to become frustrated when talking to someone with dementia or Alzheimer's. It's hard to know the "right" way to respond to the repetitive or odd things he sometimes says. You won't be tongue-tied if you keep these simple communication techniques in mind.
How to start a conversation
When you want to start a conversation or ask a question, get the person's attention in an obvious, direct way. Start by approaching him from the front and saying his name. This will help him focus on you and prevent catching him by surprise, which may set him on edge and make him less able to concentrate on the conversation. Someone who's older may be somewhat deaf, and this direct approach also makes it easier for him to hear you.
Slow down your usual speaking style a bit. Enunciate your words to be as clear as possible. Also stay conscious of giving the person plenty of time to think about what you've said and to reply. Many people have a tendency to rush in and fill a silence with more words, which often only serves to agitate someone with Alzheimer's or other dementias.
Another way you might need to alter your usual conversational style is to stick to common, plain words and short sentences whenever possible. (It's like talking to a young child, though without using singsong baby talk.) Try to construct sentences that include only one main thought, ask only one question at a time, and give instructions one step at a time.
If the person doesn't understand something you've said, repeat it exactly the way you said it the first time; that will give him more opportunities to figure it out. If you've asked a question that's not connecting, ask it again the same way. Do this within reason, of course -- if two or three repetitions fail, try rewording the message in different, simpler terms.
keeping is simple. My Mother does not want help. I need ways to let her know that I am here because I love her. Not because I am trying to control her.
It is a real concise overview of some of the major communication problems that arise. It also makes it easier for me to pass this article on to others who are confused by Mom's new behaviors.
Communication has been the hardest thing to re-learn. We've been married for 27 years and it's like starting all over again
This reminded me of what I need to do when John is having a bad moment or bad day. Thanks.
One of the comments asked for ideas for Alzheimer's patients who are blind. Have you tried making one of those aprons where you "decorate" a bib or apron with bits of interesting texture? I'm guessing you could start out with just a plain fabric and bring some items in a box, then let her touch stuff and decide if (or you could pick something and have her show where she'd like it added) she wants something added to the apron; that way she has input. also, I think it could be fun to play a form of the old TV game "Password" where you take an object and describe its qualities while your partner tries to guess what it is. That could be adapted to work with someone who is blind. You also could take a bunch of textured items, cut them in half, then put half on each of two trays or in two boxes and let the blind patient seek for a pair.
All the cues foe non intimidating conversation was very interesting to me
I think all of us as care givers forget what the loved one is going through when we start communicating to them, and forget that they can't begin to keep up with us. I have to remind myself all the time. "less is more' or too much info- short and sweet and to the point. I have to work on the "here and now" and separate that from "what she use to be"
A number of useful tips.
If I may add (to build on what was said on page three about the bird feeder) think about whether a question is what you want/need; in other words, if you pose a question instead of making a statement, be prepared to wait for and deal with an answer. Also, don't ask a question in wording that will get a "yes" then reword the same question in different words that will take a "no" for the same concept because that can lock the patient up. Use positive statement not negatives; "keep your hand open" vs. "don't close your hand". The author mentioned humor. It's a good idea to be wary of idioms that the Alzheimer's patient might interpret literally. Also, to the author: on page three, this sentence doesn't make sense to me: You can improve verbal exchanges in lots of casual names. Thanks for a great article.
Nice article. I have Alzheimer's and the approaches are good. One of the best works i haev read in awhile.
Each of the elements. I'm going to commit them to memory and try to keep them in the front of my mind. I hope to make habits of them as I communicate with my mother.
I've bumbled into these solutions on my own over time, and it's nice to see them validated. I recall after my husband's diagnosis (of vascular dementia) being motivated to treat him with consideration. (I also remember thinking hey, isn't this how you are ALWAYS supposed to have treated him? Sigh...). I agree with these suggestions, they do help with the level of peace in the house, and they also calm me when I can practice them. I just wish I were better at following them...so much of the time he's "himself", and I forget... :)
These pages have been very helpfull in visiting my sister in alzeimers facility She is 80. the youngest of three sisters trying to visit and make her life as pleasant as possible, She is a sweet person but always wants to go home and we are afraid to take her for a visit because she may not go back. I am her main contact and at 85 some what limited in what ai can do,
Slowing down when communicating and not talking down to the person
Boy, I've been through all these things with my Mom, from the hiding things, accusing people of stealing from her, stealing people's things herself,( she wants everything she see's that belongs to someone else), Aggressive behaviour, even slapping and hitting us, repeating everything over and over. Good Lord the list goes on and on. Mom's in a facility now and it's I wanna go home all the time. I had her and Dad living with me for a couple of years, then Dad passed away and it got worse. She wanted me to wait hand and foot on her because at the last I had to do that for Dad. Which she had started wanting me to do for her before he passed because I did it for him, so that was thrown up to me for months and sometimes even now with her in the home. I almost had a nervous breakdown from all the stress and load I carried. Hated to put MOM in a home and still feel so bad about it, but it couldn't be helped. It came to my health and sanity or her getting her way battles till it was to much. I see from reading your columns that somethings I did right but a lot of things I didn't for lack of not understanding this terrible affliction on MOM. I really enjoy your input and advice as it helps when I go see her and we start arguing. The nurse said when it starts out to becoming unreasonable with her to just leave because I can go home but she lives there and she was so right. Mom gets mad when I leave after a few minutes sometimes but she has a tendency to start in on me the minute I walk in. Everything is my fault that's happened to her. I've started visiting her a couple times a week instead of every other day because of the stress coping with her causes. I may be wrong in doing so but my nerves cannot take the constant badgering. Thanks again for your advise.
I appreciate your information. I am a nurse and have taken care of Alzimers patients for years. You have given good ideas on how to help with their care and gave me some new ideas. I am retired now but do stay with a friend who is also blind as well as having Alzhimers. If you have anything helpful in helping with things she may be able to do since she can'tr see I would appreciate it. Thank you.
The friend I am taking care of not only has Alzhimer's but is blind also.
I liked the article. I think it helped me emphasize accepting repeatedly conversations which can be difficult for me. Also, I like the idea of limiting pronouns.(You may want to state it that way although that's in effect what you did) Tip: Maybe avoid parenthetical expressions like "When it come down to it" "Above all" We tend to use these terms and they may not be helpful. thanks, Quiz
Puzzles you are one of a kind thanks i need to put some of your sugestions to work I sometimes forget and say never mind I do it or I get it myself ,and he wants to be so helpfull Thank you again
I am not sure his primery care doctor knows much about the problem, but my husband is in a resurge program in Sac. and the Docter there is great I can asked anything and he will answer me or els finds the answer for me That is a big help
My husband's dementia has never actually been diagnosed as Alzheimer's, but his memory is completely gone. He does know my name but forgets his daughter's and grandchildren's names, but really doesn't address anyone by name. His speech is starting to be garbled and he wants to sleep a lot. He does have a heart condition with a leaking mitral valve which adds to his being so tired, His walking is also not good and he uses a cane for balance. I wish I could always be quiet and helpful, but it is very difficult for me. I do have an aide during the week for 4 hrs. so I can have lunch with a friend once in awhile, but living with him on a daily basis is very diffucult. I love him and want him home, but other times I lose my temper and cry a lot, especially when I remember the man he used to be.
Hugs Quiz, Ms Terri
Your mother probably changes the subject because she doesn't recall the correct conversation. I wouldn't dwell on her not remembering the correct conversation, go with the one she brought up and move on. It may help if when you go to visit bring an activity to do together. I'm not suggesting something difficult like a large puzzle with 25-50 pieces, that would be frustrating for her. There are 6 piece and 12 piece puzzles by Memory Jogging Puzzles with age appropriate themes by Norman Rockwell that she could complete (she may need your help even with these small number of pieces.) Don't rush her enjoy the moment, you are making memories. Completing a task or puzzle will make her feel good and they are fun brain exercise as well. You will be able to start up a conversation about the picture if you want. There are matching games that are great to interact with her also. If she doesn't talk, that is okay... watch her facial expression and her eyes, that will give you tips on how she likes doing the activity. If she gets frustrated help her gently or stop and introduce something else. Both of you will enjoy a 15-30 minute visit with an activity to interact with more than going in to visit and sitting there trying to get her to talk about something that happened long ago or remember a conversation that wasn't quite right. If you are frustrated she will sense that and be the same way. Forget the past and how critical and manipulated she WAS, she is old now and needs a friend. Pay Forward... someday it may be you who needs a friend.
All the information was helpful. I needed this. Although my loved one has not been evaluated with Alzheimer's, her primary care physician has her taking Aricept, because she asked him for something to help her memory. I want her to get evaluated, but she gets angry when I suggest it. According to the articles here, I see she is in the early stages of Alzheimer's. Thank you so much.
all of it I have to remember to slow doun when I speek to my husband I have a habbit of doing that talking to fast thanks
writing down communications in a notebook,m mom is having a hard time speaking but can still read.I never thought about writing some things down.I think this is something she will enjoy.
Helps me to remember how to act
Thank you I have been trying to improve communication and what you said gave some very concrete help. I could see myself in some of what you wrote. One of my father's repeat phrases is slow down you talk to fast. I also do not use the person't name enough and I think that will help. Lastly we just started following up conversatins with the same thing in written form. It was reassuring to read that it is agood ides.
My 89 yr old mother has stage two AD. Conversations are rather amusing actually. Today I had a dentist appointment. Mom asked "where are you going?". I said "I have a dentist appointment to have my teeth cleaned." She asked 5 minutes later "where are you going". I said "Dentist to have teeth cleaned." She asked 5 minutes later "where are you going?". I said "Dentist". She asked 5 minutes later "where are you going". I said "out". You got to laugh at yourself. Everything in this article is so true. I'm the stubborn one and seem to not remember how to be simple. Mom remains the one with AD and the same. Some day I'll get it. I end up driving my friends crazy with long winded conversations just to hear myself say a long sentence.
goodMorning... When visiting your loved one, make it a special time both of you can enjoy. How? Take in an activity that can be done easily with guidance such as simple puzzle or games. If it has a storytelling theme you will find it easier to start conversations. Your visit will be beneficial and less stressful for you. For anonymous – my mother had a stroke followed by dementia, she became very frustrated when trying to say something and the most simple words were not there for her. It was frustrating for her and frustrating for all of us. At first thinking I was helping, I would try to help fill in the blank (guess what word she was searching for) rarely was it the correct word. I can still see her face as she shook her head in frustration. I finally learned to be more patient and understanding. Slowly the words would come, and she would smile and so would I. I wish I had those moments back again. I don’t know if it was the same thought she started, I didn’t care. Her getting those words out was a huge effort and success. The pain and frustration dementia patients go through is horrendous... hope and pray you aren’t there in her shoes someday. takeCare. karen
I do trey verry hard not to lose it but do sometimes in each case I will follow with a hug kiss and I love you
I found some of the suggestions helpful, while others seem impossible. I am a 52 year old woman with an 86 year old mother with dementia. It is especially difficult since we always had a strained relationship. She was a domineering, critical and manipulative woman. There was not much hugging going on so I find that very uncomfortable. I stick to subjects that are less antagonizing such as her childhood memories. She loves to talk about herself so retelling the same stories from her past make her happiest. When she asks the same question 5 times in 5 minutes I just keep answering them and try to steer the subject to something else. Not sure what to do when she asks to talk to my father and brother, both having passed away years ago. Sometimes I remind her of that, other times when she is yelling, and demanding to get their phone number, I say they're "out" and will call her later. Any suggestions as to what to do in this case? She is in an assisted living facility, so I have the peace of mind that her physical and mental needs are being met, but the phone calls she makes to me and the visits to her are truly a draining, stressful experience. It's especially hard having to do this around a stressful, full-time job, so visiting her every day is out of the question. I guess you just have to do the best you can in your particular circumstance and be satisfied with that, then let it go.
Thank you so much for these helpful hints. My Mother-in-Law has always been a very independent, take-charge woman and is now very frustrated whenever she cannot find the right word. We try to give her the time to figure out what she wants to say, but she usually will change the subject completely and repeat something she had just said a minute or so earlier. It helps to know how to handle these different situations.