San Diego caregivers need the help, support and direction of Geriatric Care Managers in learning to work with Alzheimer’s patients and those with other forms of Dementia. With nearly 50% of all seniors over 80-yrs old having some form of Dementia, Geriatric Care Managers are in the position of teaching caregivers and family members how to communicate with their loved ones. The following list of “do’s” and “don’ts are important reminders that even though an elder has memory deficits and cognitive decline, their human dignity is still very much intact. Kindness, compassion and learned communication techniques can make all the difference.
Here are a few of the most important principles of “compassionate communication” with Dementia patients. Caregiver “do’s and don’ts” benefit of the Alzheimer’s Association.
- Don’t reason
- Don’t argue
- Don’t confront
- Don’t remind them they forget
- Don’t question recent memory
- Don’t take it personally!
- Give short, one sentence explanations
- Repeat instructions or sentences exactly the same way
- Allow plenty of time for comprehension
- Eliminate “but” from your vocabulary; substitute “nevertheless”
- Agree with them or distract them to a different subject or activity
- Accept the blame when something’s wrong (even if it’s fantasy)
- Leave the room, if necessary, to avoid confrontation
- Respond to the feelings rather than the words
- Be patient and cheerful and reassuring – go with the flow
- Please elevate your level of generosity and graciousness
- They are not crazy or lazy. They are saying normal things, and doing normal things, for an AD patient. If they were doing things, or saying things, to deliberately aggravate you, they would have a different diagnosis.
- Some days they’ll seem normal, but they’re not. Their reality is now different than yours and you cannot change them. You can’t control the disease. You can only control your reaction to it.
- Their disability is memory loss. They cannot remember and can’t remember that they cannot remember. They’ll ask the same question over and over believing it’s the first time they’ve asked.
- They do not hide things; they protect things by putting them in a safe place and then forgetting they’ve done so. Do not take ‘stealing’ accusations personally.
- They are scared all the time. Each patient reacts differently to fear. They may become passive, uncooperative, hostile, angry, agitated, verbally abusive, or physically combative. They may even do them all at different times, or alternate between them. Anxiety may compel them to follow you everywhere. They can’t remember your reassurances. Keep saying them.
San Diego caregivers should remember how important it is to structure daily care when dealing with their patient or loved one with Dementia. Familiarity and consistency is a great comfort to elders with Dementia. Routine conveys security and a sense of visceral continuity even while their continuity of memory is failing.
Like the rest of us, elders with Dementia need to be loved and cherished and respected for who they are. One woman we care for in her mid 80’s has developed a new talent for portrait painting and has regained a new, joyful sense of herself in this artistic expression. She feels whole when she paints. Focus on the positive and what is meaningful and pleasurable in the elder’s life. Maximize relationships with family and friends. A dearly loved pet can be as good as any medicine on the market. Maximize all opportunities for connection and affection and being “useful,” or needed.
San Diego caregivers must take care of themselves as well. If they are getting tired and burned out, they should ask for help. Contact the Alzheimer’s Association for support groups and various supportive interventions. If you are a family member of a loved one with Dementia and have caregivers that care for them, consider hiring a professional Geriatric Care Manager to assist and support your caregivers as well as the family. You don’t need to walk through this alone.
Information from the Alzheimer’s Association at www.alz.org.