Alzheimer's A to Z

with Dr. Jytte Fogh Lokvig


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Communication

The most common issues for caregivers are so-called “problem behaviors.” More often than not, these “problem behaviors” arise from a lack of understanding dementia communication. Many of our cultural norms no longer work. If we listen to ourselves in normal conversations, we'll notice how frequently we use words and terms that relate to memory. Wouldn't it make sense that people with memory loss would be lost or react negatively to our "normal" conversations?


Here are some basic guidelines to adapt ourselves to this new way of interacting:


Communication

Avoid: “Do you remember?”

Use with care: “Do you want?”

Never argue or admonish

Respect  altered  realities

Use Diversions and Apt Responses


Compliments go a long way!!


Ask for help

Use humor

(Laugh with people, never at them)



Avoid the word NO


Verbal traps that challenge a person’s memory:

“Do you remember . . . ?”

Instead, start with a description of the event or person you want to talk about:

“I was just thinking of your friend Sally whom we ran into a few days ago. You really liked her new dog, that cute little brown poodle.” At this point you may see that glint in her eyes that tells you she follows what you’re talking. She may join in and add to the conversation or she may just choose to listen as you reiterate your visit that day. When you use story telling to share particularly joyful experiences in all the glorious details, you open an opportunity to relive them. If the stories are particularly pleasurable, they may bear repeating often. Good anecdotes can be used as effective diversions. When you retell these shared experiences with delight, you’re not only given her the joy over again, but you’re letting her know by your attitude how happy you are that she was there sharing with you.



Use with care: “Do you want?” unless she can see what you’re talking about.

Example: You can hold up two tops and ask which she wants to wear that day.


Try not to ask “Do you want?” about something that she cannot see, unless you already know the answer, as in: “Do you want ice cream?”


As you get used to this kind of communication, you’ll find it much easier to deal with

the more challenging situations.


A couple of rules of thumb:

• Ask questions that only require a YES or NO answer (mid/late stage dementia)

• Ask a question in such a way that you’re most likely to get the answer you want:


NOT: “Do you want to take a bath?” is almost guaranteed to solicit a resounding:

“NO!”


Instead, try this:

“Friday’s a good day for a bath, don’t you think?”

Or:

“I promised to remind you that you want to have a bath today.”