Family Caregivers Communication Class — The Language of Dementia, Part 3

This is Part 3 in a 3-part series.  Please click here to read Part 1 which contains the background ideas these lessons are built on. Also read my brief “Word of Warning” in Part 2 to keep from “shoulding” all over yourself and for a prior lesson in the language of dementia.

I hope you are starting to get the hang of communicating more effectively with your aging parents who have memory loss, dementia or Alzheimer’s disease (AD).  The very first step is becoming aware of what words we choose and how these words can help us reach the goal of making daily life with them as stress-free as possible.

Have you been practicing this “new language” in conversations with your Golden Oldies?  Can you see why we’ve identified some things as Don’ts because the words used can trigger anxiety and/or arguments with our care recipients? Are you starting to apply some of the Do’s that encourage peaceful and more fruitful verbal exchanges?

Remember, learning a new language takes time and repeated practice so be patient with yourselves.  Now on to a few more Do’s and Don’ts in this lesson.

Don’t Reason or Argue

It is hard to break our “normal” patterns of communication.  When someone asks you a question, you answer it logically — right?

Well, not when it comes from a memory-impaired individual.  Here’s an example:

Golden Oldie with AD: “What doctor’s appointment? I don’t need to see the doctor.  There’s nothing wrong with me.”

One response:  “You’ve been seeing Dr. So-and-So every three months for the past year. It’s on the calendar and I told you about it yesterday and this morning.”

Instant Replay:  “It’s just a regular checkup.  I’m sorry if I forgot to tell you.”

Some Do’s illustrated by the above exchange are:

• Give short, one sentence explanations.

• Accept the blame when something’s wrong in the memory-impaired person’s mind, even if it’s a fantasy.

OK, it’s true confession time again.  Here’s a conversation I had with my mom when she was in the earlier stages of AD:

Mom:  “I can’t find my purse.  Someone must have stolen it from my apartment.”

My reply:  “What?  Don’t be ridiculous, Mom!  No one has burglarized your home. You must have misplaced your purse.  Let’s look for it.”

Instant Replay:  “That’s a scary thought, Mom.  I’ll make sure the alarm is working properly.  Would you help me fold the laundry?”

The Instant Replay response (if I only knew then what I know now) is preferable because I:

• Respond to feelings (fear or anxiety), rather than the words.

• Am being reassuring and patient.

• Distract them to a different subject or activity.

Simplify, Simplify, Simplify

Open-ended questions are very hard for a memory-impaired person to process as well as reply to, and can create anxiety in them. For example:

Son:  “Dad, where should we go today?”

No response.

It is wiser to give them a simple choice between two things, or even direct their choice, such as:

Instant Replay #1:  “Dad, should we go to the park or the library today?”  OR

Instant Replay #2:  “Dad, it’s so warm and sunny outside, let’s go get some ice cream.”

Allow lots of time for comprehension; then triple it in all conversations.

Try to repeat instructions or sentences in exactly the same way.  Even changing one or two words can confuse a person with dementia.

Spouse: “Please drink your milk. (pause) You need to drink all your milk.”

Instant Replay: “Please drink your milk. (pause) Please drink your milk.”

Keep in Mind

Our goal is to keep our dementia care recipients as calm and anxiety-free as possible every day. This will help to increase their quality of life tremendously.

Memory loss progresses daily, so please do not take it personally if your care recipient speaks hurtful words to you.  Try putting yourself in their place and imagine how afraid you would feel.

Practice compassion and generosity in your words and actions daily.

How are you progressing in mastering this new language?

If you have challenges you need help with or have examples of verbal exchanges you’d like to share, please leave them in the comment section below and I’ll be sure to reply.

Outside Resource:

Compassionate Communication with the Memory Impaired by Liz Ayres

Related posts:

• Family Caregivers Communication Class — The Language of Dementia, Part 2
• Family Caregivers Communication Class — The Language of Dementia, Part 1
• Family Caregivers Communication Class — Part 5: How to Talk with Aging Parents When They Can’t Speak
• Family Caregivers Communication Class — Part 4: Talking with Hearing Impaired Aging Parents
• Family Caregivers Communication Class — Part 1: Think Before You Speak