This is a favorite discussion of mine because I remember when I cared for mom and the caregivers would tell her “Momma speak English”. I would constantly remind them that she “Speaks Alzheimer’s” and that they needed to learn her language, not the other way around. Little did I know that when I took my training to be certified as an Activities Director I learned that caregivers do indeed need to communicate with persons who have A.D. in their own language. Because I lived with mom every day, I did learn her unique language so here are some additional tips for those family caregivers and/or paid caregivers who need to communicate with the Alzheimer’s patient.
If you really need to be heard, make sure that you have the person’s attention by saying their name and making eye contact. Remember cognition level may vary from day to day, time of day, location and conversational topic. Limit the number of people in a conversation when you are communicating. Use short, simple words and sentences with minimal information. This really makes life easier all the way around. Reduce distractions and extraneous noise when trying to communicate. Use more than words to communicate. Body language, gestures, and facial expressions also communicate meaning so learn to use appropriate ones. Encourage the person to express thoughts even if having difficulty. Be careful not to interrupt them. Demonstrate tasks in easy to understand steps, one at a time. Use recognition rather than recall questions when introducing someone. Try saying, “This is Maria who we met last summer”, instead of saying “Don’t you remember Maria from last summer?” Expect that the person may ask the same question over and over again. Repetition is very common in this disease. Try to have patience, be reassuring, and move on. While on the subject of patience, ask one question at a time. If asking a question, then wait for a response. Sometimes there may not be a response, so gently move on. Above all, and this is very critical and may take some practice, but you must avoid criticizing, correcting, and arguing. It is always counterproductive. Remember, you can no longer teach them something like you can do with a two-year-old, it is up to you to:
If you really need to be heard, make sure that you have the person’s attention by saying their name and making eye contact. Remember cognition level may vary from day to day, time of day, location and conversational topic. Limit the number of people in a conversation when you are communicating. Use short, simple words and sentences with minimal information. This really makes life easier all the way around. Reduce distractions and extraneous noise when trying to communicate. Use more than words to communicate. Body language, gestures, and facial expressions also communicate meaning so learn to use appropriate ones. Encourage the person to express thoughts even if having difficulty. Be careful not to interrupt them. Demonstrate tasks in easy to understand steps, one at a time. Use recognition rather than recall questions when introducing someone. Try saying, “This is Maria who we met last summer”, instead of saying “Don’t you remember Maria from last summer?” Expect that the person may ask the same question over and over again. Repetition is very common in this disease. Try to have patience, be reassuring, and move on. While on the subject of patience, ask one question at a time. If asking a question, then wait for a response. Sometimes there may not be a response, so gently move on. Above all, and this is very critical and may take some practice, but you must avoid criticizing, correcting, and arguing. It is always counterproductive. Remember, you can no longer teach them something like you can do with a two-year-old, it is up to you to:
- Treat them with respect and dignity and not as if she/he were not there. I had a family member who was so happy to see me that she would have conversations about him in the third person in front of her husband with A.D. Years later I learned that after I left he would always act out in anger.
- This one is crucial. Simplify tasks. Break down tasks and activities into easy steps. Limit choices. Allow time for their slower processing time. Reassure the person with each step (i.e., “you are doing great”).
- Maintain a calm soothing environment. Soft sounds and voices are best. Music can be very comforting. Give a reassuring touch when appropriate. Avoid abrupt movements. Keep the environment as consistent as possible.
- Know what to do if the person becomes agitated. Try to figure out the source that’s upsetting the person with A.D. Does he/she need to use the bathroom? Are they in pain? Change the subject if it appears to bother them (also known as redirecting which is successfully used in long term care). Distract and move on to a different activity.
- . Use their view of reality. Reality orientation is not effective with those who suffer with severe memory loss, so validate them because their reality is different from yours. Whenever possible, go along with the person and ‘be in their world’. Don’t argue as it will not be productive. Practice reminiscence (recalling past events). Focus on pleasant experiences and achievements.
If you or your loved-one’s staff needs to learn to speak Alzheimer’s, use these tools. If you are a long distance caregiver and need someone to partner with you in achieving goals for someone dear to you, call the offices of A Good Daughter Elder Care Management in Boca Raton at 561-392-3574. We will be happy to discuss how we can be of help. Our support group for family members meets on the third Wednesday of the month from 5:30 – 7:30 pm and is free of charge.
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