What words bring comfort to you…. cat, dog, mom, church, maybe even the word blue brings a sense of calm to you? Why do you suppose these words hold some sort of importance to you? Chances are they evoke feelings from somewhere deep inside you. If you think of a word as an emotion, rather than as the item the word describes; your new found ability to communicate could be the key that opens the door of understanding to communicate with a person living with Alzheimer’s.
Not only words but familiar surroundings like sitting at a dinner table or passing a church can bring emotions to the surface. How about a familiar task such as folding laundry or washing dishes? What about a picture of a baby or a picture of a field of flowers? All of these simple things we may take for granted every day may have great meaning for a person living with Alzheimer’s. When I hear the words “homemade bread” or even bread pan….. I smile. It takes me back to the feeling of being loved by my Gram. All her hugs and kisses she bestowed upon me throughout her life. It also can bring back sadness. I miss the wonderful smell of baking bread as I entered her kitchen. I miss my Gram.
When your loved one says a word. Don’t take it for its literal meaning. Take a minute and think about what may revolve around that word. It may take them back in time, unlocking emotions from deep within their heart. Instead of just listening with your ears…..Listen with your heart. Let the true communication begin.
“What do you mean?” and” I don’t understand “… As a caregiver for a person living with Alzheimer’s, these phrases can be frustrating. Something that seems simple to us, such as, saying ” Let’s go this way”, then just walking away …..Can make the PLWA feel abandoned and frustrated. The words must sound more like Whant, Whant, Whant and Blah, Blah, Blah than an actual request or suggestion. Instead of just saying something to them, take the person by the hand or make a forwarding gesture as you say “Let’s go this way”.
What about after your sixth try to assist your loved one to the restroom. You finally get them to the restroom, give their pants a tug and say “Ok, now pull your pants down”. Just for them to look at you like you are crazy and cling to their pants with clenched fists. They probably feel vulnerable and afraid which may lead to anger. This anger may lead to aggression. Wow…… this situation just got bad in a hurry. But why? You have a request and made a simple gesture…Think about the intimacy involved in using the restroom and the trust the PLWA has to have with the person assisting them. Does their reaction make sense now? Use step by step instructions with non-invasive gestures. Take your cues from them….. They will let you assist them when they feel comfortable and safe with you.
It takes patience, lots of patience. Sometimes it will be a success and sometimes it won’t. Trial and error…… Keep trying. What works today may not work tomorrow. Remember, you are not the only struggling caregiver. With support from others like us. You can hold our caregiving head up high and say, “I Can Do This!!!!”
I have never been a morning person. You can ask my husband or my children and they would all agree….. coffee first…. conversation later. How do you feel in the morning? If you’re anything like me…. your head is foggy, your joints are stiff and your tongue feels like sandpaper. If you were a person living with Alzheimer’s, add the confusion of not knowing where you are or who is in the room with you or why are you cold and wet? I don’t know about you but I’d be afraid, probably very afraid.
Now this strange person is saying something about clothes and a bath….. you don’t understand…The person reaches for you and you say “No” and pull away from them and try to get through the doorway. You’re still cold, a little unsteady and that person is still following you saying words you don’t understand and reaching for you. Sounds pretty terrifying to me. You might start swearing, crying or even hitting this strange person.
Wow ….. I thought my mornings were tough. How can we as caregivers make mornings less stressful for everyone? A smile and a soft gentle voice may help. How about a familiar tune to set the mind at ease. Remember, if we were lucky enough to sleep for six or more hours we’re probably thirsty and hungry. Try offering a favorite drink or food. Is there a favorite robe or stuffed animal that brings them comfort. Most of all be patient. It may take fifteen minutes or maybe hours to regain their trust.
Remember every day is a new day. So turn on a tune, enjoy a cup of coffee and be patient with yourself. It’s gonna be a good morning.
Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.
Sundowning can continue into the night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.
The causes of sundowning are not well understood. One possibility is that Alzheimer’s-related brain changes can affect a person’s “biological clock,” leading to confused sleep-wake cycles. This may result in agitation and other sundowning behaviors.
Other possible causes of sundowning include:
Look for signs of sundowning in the late afternoon and early evening. These signs may include increased confusion or anxiety and behaviors such as pacing, wandering, or yelling. If you can, try to find the cause of the person’s behavior.
If the person with Alzheimer’s becomes agitated, listen calmly to his or her concerns and frustrations. Try to reassure the person that everything is OK and distract him or her from stressful or upsetting events.
You can also try these tips:
Being too tired can increase late-afternoon and early-evening restlessness. Try to avoid this situation by helping the person:
Avoid things that seem to make sundowning worse:
If medication is prescribed to help the person relax and sleep better at night, be sure to find out about possible side effects. Some medications can increase the chances of dizziness, falls, and confusion. Doctors recommend using them only for short periods of time.
Due to complex changes occurring in the brain, people with Alzheimer’s disease may see or hear things that have no basis in reality.
If a person with Alzheimer’s has ongoing disturbing hallucinations or delusions, seek medical help. An illness or medication may cause these behaviors. Medicines are available to treat these behaviors but must be used with caution. The following tips may also help you cope with these behaviors.
Here are some tips for coping with hallucinations and delusions:
In a person with Alzheimer’s disease, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:
Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.
Here are some tips for coping with paranoia:
Also, keep in mind that someone with Alzheimer’s disease may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with Alzheimer’s. For more information, visit Elder Abuse.
People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.
Most of the time, agitation and aggression happen for a reason. When they happen, try to find the cause. If you deal with the causes, the behavior may stop. For example, the person may have:
Look for early signs of agitation or aggression. If you see the signs, you can deal with the cause before problem behaviors start. Try not to ignore the problem. Doing nothing can make things worse.
A doctor may be able to help. He or she can give the person a medical exam to find any problems that may cause agitation and aggression. Also, ask the doctor if a medicine is needed to prevent or reduce agitation or aggression.
Here are some ways you can cope with agitation or aggression:
Here are some things you can do:
When the person is aggressive, protect yourself and others. If you have to, stay at a safe distance from the person until the behavior stops. Also, try to protect the person from hurting himself or herself.
You and your loved have now entered the diagnosed stage seven of dementia. You have struggled through the confusion of “What is wrong with my loved one?”, the loss of dreams with the initial diagnosis, watching the gradual decline of their cognitive abilities and now their physical abilities are diminishing. How do you continue to communicate?
Having worked in a nursing home activity dept I learned that communication drastically changes during this final stage. Words no longer have the same meaning or any meaning at all. Touch and gestures become your trusted connection to helping the individual living with Alzheimer’s navigate this final stage. These suggestions may seem difficult for some because they are more intimate ( unless you’ve helped with personal care) than other means of communication…. Holding hands, applying lotion to arms and legs, brushing hair, washing hands and face and polishing fingernails are just a few suggestions.
Just because someone can no longer verbally communicate doesn’t mean they won’t enjoy hearing you talk to them. Make eye contact and be animated…..widen your eyes or wrinkle your nose. Talk to them about their former occupations, the hobbies they once enjoyed or just talk to them about the weather. The gift of gab can be a very important trait for a caregiver. Read to them… the newspaper, a short story or passages from the Bible. Play music for them ….. tap them gently on the arm to the beat of the music or sing to them. Sometimes just the presence of another person close by is comforting…..a touch to their hand or forearm may be all they need or can tolerate. Remember to take your cues from the person living with Alzheimer’s. Pay close attention to their facial expressions or attempts to move their arm or hand away from your touch to ensure they are comfortable with the interaction.
Never underestimate the power of a smile. Most people can’t help but smile back when someone smiles at them. Why would that be any different for someone living with Alzheimer’s? Smiles are inviting and contagious. One smile… happy or sympathetic can set the tone for the whole interaction. Communication is not always about what you say, but about how you make someone feel. Make them feel safe, loved and understood…. there are no better feelings in the world.
Communication is hard for people with Alzheimer’s disease because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they can’t.
The person with Alzheimer’s may have problems with:
Also, Alzheimer’s disease causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, he or she might understand and use only the first language learned, such as Spanish.
The first step is to understand that the disease causes changes in communication skills. The second step is to try some tips that may make communication easier:
To encourage the person to communicate with you:
To speak effectively with a person who has Alzheimer’s:
Here are some examples of what you can say:
You also can:
If you become frustrated, take a timeout for yourself.
Alzheimer’s disease is being diagnosed at earlier stages. This means that many people are aware of how the disease is affecting their memory. Here are tips on how to help someone who knows that he or she has memory problems: