Communicating effectively with a loved one with Alzheimer’s can be challenging and difficult. As the disease progresses we need to expand our capabilities to meet our parent, partner, or friend exactly where they are in an appropriate and loving manner. A person with Alzheimer’s experiences good days and bad, just like everyone else. As caregivers, learning to navigate all types of days is imperative. Here is a brief list of communication tips and some ideas about how to navigate invariably difficult situations.These tips are intended to help you engage with insight and compassion without having you drain your own personal reserves.
When you are with your loved one, be present. Make sure you aren’t distracted. Maintaining an environment that is calm and focused can avoid anxiety from building, thereby creating a space where your loved is at ease and safe.
Try to stick to one subject at a time. Varying the topics within a conversation can lead to confusion. Staying focused allows your loved one to concentrate on the conversation without necessarily getting frustrated or anxious.
Take your time and have patience. Don’t expect quick answers to your questions. You need to give your loved one time to consider how to respond. As the disease progresses, realize that they may be unable to respond to your questions or interact in a simple conversation.
There might be a time when the majority of communication will be nonverbal or when they become very useful as your loved one slows down in basic conversations. Using nonverbal cues such as eye contact, a smile, or just projecting a gentle presence helps to promote an air of ease and allows for increased understanding. Keep things simple and focused. When dementia is advanced, this may be the only mode of effective communication.
Active Listening Not Arguing
If a loved one says something that is unclear or you don’t understand, tell them. See how they respond. If they don’t clarify, let it be. And when your loved one says something that is absolutely inaccurate and fantastic like “I had dinner at the bathtub last week with Max and he wants me to go into business with him,” please let it go. Numerous confusions are at play here, especially when you know that Max died twenty years ago and that he and your loved one started a great architecture company together. Trying to correct someone who logically believes that what they just said has merit is upsetting and confusing. Instead, perhaps ask them about the dinner or Max. Let them tell the story that is swimming through their head and listen without expectation.
Also, use names and be clear. When greeting your loved one use your name and avoid pronouns. Say “Hi Mom, it’s me, Lily”. Don’t condescend or use baby talk.
How to Calm Down a Situation
There are often behavioral changes that accompany Alzheimer’s, so there will be days when your loved one is upset and agitated or quietly depressed and withdrawn. As you can imagine, not being able to express something or reach a memory and share it is frustrating; you don’t understand why you can’t get to it and at the same time you know that something has evaporated, left you forever and you are at a loss. Compound this with not being able to express to your caregiver that all of this is going on while they are trying to get you to do something or go somewhere. It is one of many situations that can lead to agitated outbursts or deep silences that can be really draining and difficult to handle.
It is times such as these, when you need to know what is soothing for your loved one. Initially it may be taking a deep breath, looking into their eyes with love, softly holding their hand or gently putting your hand on their back to let them know that they are supported. What is important here is to surrender your agenda and to meet your loved one exactly where they are. Be with them intently and gently until they get that they are not alone. Be sure to find a way to connect with them. Make sure that they are comfortable. Make sure that their bodily needs have been met. Are they too cold or too hot? Often times it is the simplest of needs that have not been met, and their inability to communicate, that leads to a meltdown and outburst.
As a caregiver, we learn through time and trial what is needed and how to navigate through these issues. Know that this is a difficult issue to anticipate and that you will not always be able to avoid the outburst or upsetness of your loved one. What you can do is try to bring a calm peaceful heart to the situation.
Also, for many suffering from Alzheimer’s and other forms of dementia, music can be very soothing. It is useful to have some of their favorite music close at hand. It can provide a strong sense of safety and familiarity without being confronting or challenging.
Loving and caring for someone with Alzheimer’s is one of the most challenging circumstances anyone can encounter. Know that you are charting new waters while doing the best you can, forgive often, get support, arrange your life so that you get breaks, and share with others what you are dealing with and learning. Laugh whenever you can. Taking great care of yourself will be one of the best things you can do to meet all the challenges of caring for your loved one with an open heart and a powerful presence.