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The other day I happened upon an incident with an older man suffering from Alzheimer s who was convinced that a nurse had said he was despicable and he was demanding an apology. If anyone came near him to talk, he started physically striking back. The staff tried deflecting the conversation to calm him down. It took a half-hour.
The man s wife was mortified and, she too, did not know how to talk to him. Most of the time, his demeanor is kind and gentle. There was no reason to believe that the nurse said he was despicable. But in his mind, in his reality he had been deeply insulted and hurt.
Episodes like this are played out every day in people s homes, assisted living facilities, nursing homes and hospitals. No one escapes the toll of frayed emotions not the caregivers, nurses, doctors, husbands, wives, adult children or the loved one fighting through the disease.
What makes this even more daunting, is a report issued a few weeks ago from the Alzheimer s Association announcing that a woman's estimated lifetime risk of developing Alzheimer's at age 65 is 1 in 6, compared with nearly 1 in 11 for a man. In fact, women in their sixties are now twice as likely to develop Alzheimer's over the rest of their lives, as they are to develop breast cancer. And they are two and a half times as likely to care for a spouse with Alzheimer s.
Thus, incidents like that of the resident whose personal integrity had been so severely wounded that he would wage war with his caregivers will continue to play out in the decades ahead. So, let s talk a few moments to learn how to communicate with a person suffering from Alzheimer's.
In her book, "Talking to Alzheimer's," author Claudia J. Strauss suggests that you calm down before you walk in to visit. Your goal is to get yourself emotionally ready and to be at ease. Take some deep breaths, envision your favorite soothing place, or call up the feeling of someone rubbing your shoulders or back. Relax. Why? You'll want to convey a sense of peacefulness and readiness to enjoy your loved one when you enter the room. You're creating an oasis during your visit. You'll want to give off "good vibes," because that's what your loved one will pick up. It's best to enter the room with something like, "Hi, Dad, it's me, Linda, your daughter," so he won't have to guess or be embarrassed if he doesn't recognize you.
Here are some other tips:Ask questions that have a yes or no answer. An open-ended question like "How is your day going, Mom?" is an exception, because it is in the here and now. Avoid questions that require retrieving information from memory. You don't want to place your family member on the spot so that she becomes embarrassed or angry with herself for not being able to remember.Show interest in what your loved one is saying. Maintain good eye contact, and don't interrupt or argue. Your loved one needs to know that you care about what he's telling you.When holding a conversation, keep distractions to a minimum and use short sentences in plain words. But don't use "baby talk" or talk in front of your loved one as if he isn't in the room. Use visual cues. Point to what you are referring to (for example, the bathroom), use a picture board, or make gestures. If your loved one is able to, ask him to show you what he means by doing the same. Or if he can't find the right word, try to guess the correct one.Break down tasks or instructions into concrete, simple steps. Don't overwhelm your loved one with logic or quiz them. Remain patient while he gives a response; he needs the added time to process his answer. Approach from the front when you're speaking. Coming from behind might be startling. Don't correct or argue with your loved one. This will only frustrate both of you. Logically reasoning with someone to prove your point who no longer has that capacity simply won't work. Disengage from the situation for a few moments; give each other some space and then re-engage speaking in a very calm tone of voice. You also might find it helpful to validate your loved one s feelings rather than arguing with them. For example, lets go back to the older gentleman who was angry at the nurse who he claimed called him despicable. Another approach could have been, John, that must feel very hurtful when someone says something like that and then let him express what that feels like for him. This leaves an opening for the nurse to say, I would never want you to feel that way, John, from something I ve said. I m sorry if that s what you ve heard me say, it was never my intent. And then quickly move onto a conversation or activity that he is known to enjoy.
To gain an excellent understanding as to how Alzheimer s affects the mind be sure to watch the at their website (alz.org) and if you want to watch a short video on how to handle hurtful things a person with dementia may say to you, go to .Dr. Linda Rhodes is a former Secretary of Aging and author of "The Essential Guide of Caring for Aging Parents." You can reach her at firstname.lastname@example.org.
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