What information can I give dad so he doesn't stress out mom who has Alzheimer's?
My mother has mild Alzheimer's - she seems to get worse when she is stressed? My father is the primary care giver and he actually gets her more worked up. How can I provide information to my father on how to treat her as a patient rather than his wife? She is also having knee surgery next week and I am very concerned about recovery and my fathers plans to take her on a trip. Any resources, suggestions...
Expert Answer
Before we get to the general issues in your question, let's acknowledge that taking a trip right may not be the best idea. Anesthesia and the physical trauma of surgery often aggravate dementia and most knee surgeries require specific rehabilitation and possibly physical therapy. Your mother's surgeon should have discussed this with your father.
People in the earliest stages of Alzheimer's still act deceivingly "normal." They still look the same, their voices haven't changed and the memory problems don't interfere drastically with daily functions. Family members may be skeptical that the diagnosis is actually correct and try to carry on as usual, secretly hoping that they will be the exception and their loved one will return to normal. Of course this is unrealistic and unfortunately the results of this denial often leads to a lot of unnecessary frustration and emotional grief.
Although every case of Alzheimer's is unique, there are common symptomatic behaviors. Fortunately for caregivers and families there are also a few tips to more effective interactions and communication with our loved ones.
"¢ Never argue or admonish: You'll never win an argument with a demented person. You may succeed in silencing her, but you're likely to make her depressed, uncooperative, and possibly agitated.
"¢ Avoid "Do you remember?" type questions: It's surprising how often we use this innocent phrase in our conversations. It's a way to reconnect us, but it can immediately push away and alienate a person with memory-loss, because she does not remember. Instead you can approach a shared reminiscence by telling it as a story or anecdote.
"¢ Use Diversions: It can be hard for a person with dementia to get off a track of thought. Just like you may have problems getting rid of a song running in your head, a person with dementia may fixate on a single idea and will need an outside distraction to get off that track. Distractions can be a project, a bowl of ice cream or a good story or joke.
"¢ Listen! - and take your time: It's easy to lose patience with a person who has difficulty with speech or thought processes. We have a tendency to ignore or dismiss her when she doesn't make sense. This may cause her to feel alienated and she may express her displeasure with agitation or anger.
"¢ Avoid Babytalk: Use normal adult speech and don't be condescending (harder than it sounds.)
"¢ Use compliments and humor (a lot, - but never at your companion's expense)
Bad communication easily creates a vicious cycle: stress aggravates Alzheimer's and dementia, which exacerbates the behavior, feeding your father's negative reactions, which further alienates and stresses your mother and so on.
The most commonly frustrating issue for caregivers of a person in the early stage is the repetition of the same question over and over again. It's tempting to tell her in no uncertain terms that you've already answered and her behavior is driving you crazy. You probably don't realize that when she asks you the same thing for the umpteenth time, to her it's a brand-new question that just popped into her head. When your response is anger, which can cause her to feel distressed, alienated and confused.
If this or something similarly frustrating is occurring with your parents, ask your father to try a diversion. You can help him develop some purposeful projects for your mother, such as sorting, writing shopping lists, or any kind of housework "“ anything to get her mind on to a different track.
If your father is reluctant to heed outside advice, your best bet is a local support group for the two of you to attend. You may have to go by yourself first and then bring him along to later meetings. A websearch for "effective Alzheimer's communication" will open a treasure trove of resources.