Early in my career, I developed the “Dos and Don’ts” on communicating with someone who has memory loss. As I recently reviewed those items, I realized expanding upon my suggestions of how to communicate to reduce behavioral issues could also help the individual with a memory challenge feel heard.
Imagine someone saying to you, “Don’t you remember?” several times in a row; or friends and family asking why you missed an event that you would have loved to attend. Think about all those activities you do in the course of running your life–shopping, cooking, taking medication, managing your finances and social calendar–all becoming a challenge to you. Most of us would not have a good sense of self – especially in the early stages of a disease like Alzheimer’s.
Those with a dementia sometimes blame others for taking items they can’t remember where they were put, or insist they were not told of an event. This can come across as hurtful, but it is a natural defense mechanism to protect the sense of self. It will be up to the caregiver to avoid attempting to reason, explain, or correct, and also to come up with creative ways to help prevent these incidences.
My next free Zoom class will be about preventing caregiver burnout. One way to keep from feeling overwhelmed with your caregiving is to learn better ways of communicating and strategies for overcoming challenges.
- Blaming Others for Lost Items: Technology stickers are a useful tool for locating frequently lost items – keys, glasses, hearing aids, phones, television remotes. That way you can just agree that it is missing and use the technology to locate it. Instead of correcting, just help the person find the item. Once the item is found, distract the conversation from the targeted culprit. If the lost item is something not tagged – just help look for it and if not found, acknowledge the frustration/loss (“I’m sorry ‘x item’ is missing.”) and again use distraction.
Note: Sometimes the individual is experiencing paranoia or delusions which are fixed–every day the individual with a dementia is looking for the same item. This could just mean that this individual is looking for what is missing in them. There must be something missing or they would not be this anxious. This is part of the disease. Again, distraction is your best intervention.
- Missed Appointments: Frequently missing appointments or social gatherings is often one of the early signs that something is “off”. You can help by creating a weekly calendar for them. Print the calendar and discuss events for the upcoming week, then follow up with a reminder the night before and the morning of the event. While this may sound like a lot of work, it is one way of helping some people remain independent or co-dependent longer. Smart phones can also serve as a tool for reminding individuals of events, but the events/reminders must be input correctly, and the person needs to know how to use their phone.
Note: For those in the middle stage of a dementia, usually only the day before or the morning of reminder of an appointment is given. This reduces confusion and anxiety.
- Orientation: Many families feel they must continually correct misinformation. This can lead to behavior problems or a sense of failure in the person with a dementia. If someone thinks the current month is March when it is July, there is no reason to correct that misinformation. However, if they ask you what month it is, be truthful. If the information they are stating is not correct, it is fine to go along with it and again change the subject. The exception is when the content is something that could cause harm, such as calling the police because of the paranoid delusion. You can say you will call with your cell phone and then pretend to do a call while reassuring the individual that they are safe.
Changing old ways of communicating means less sharing of family information and less sharing of issues that involve choices. Couples have a hard time shifting this pattern because you might have always shared information about extended family health issues or had a partner to share conversation regarding daily activities or current events. Because of the cognitive changes in your family member, this information can cause anxiety. Support groups are wonderful resources for couples as well as solo family members. Check your local Alzheimer’s Association for a list of upcoming group meetings.