| Communicating With The
Person With Alzheimer's - Hosted Chat Session, March 14, 2005,
with guest speaker Jo Huey, MSS, Director of Alzheimer's Residential
Care Homes in New Orleans, Louisiana.
<Q1>
My Aunt has Alzheimer's, her only caregiver is her daughter.
Her daughter is constantly correcting her about everything.
I have tried to tell her don't worry about the things that
do not make any difference. For example if she had a big
meal and someone asks her what she had to eat, she says
not that much. My cousin feels the need to correct her about
that. What can I tell her to do to help?
JO Huey:
You are correct your cousin shouldn't be correcting her
mother. However, it is very difficult, especially for the
primary caregiver to not attempt to avoid embarrassment
so they correct them. Ultimately, this is more embarrassing
for them and causes strife. I usually have the best luck
in discussing the manifestations of the disease with the
caregiver. Often few people understand how the disease works
and they think if they correct and remind the person will
understand. Would she be willing to talk to me or read my
book?
<Q1>
I don't really think she would read the book.
<Q2>
How do you get your loved one to stop asking you the same
question, over and over again?
JO Huey:
I have a dear friend who always said that they used the 1,
2, 3 times and he would change the subject. They are asking
over and over again because they truly don't understand nor
remember what you just told them. They are probably bored
or stressed or both. Change the subject to something more
pleasant, reassure them and be sure you are taking care of
you. They will pick up on your stress and become more anxious
and it is a vicious cycle
<Q3>
How do you overcome initial resistance when you want your
loved one to go somewhere they don't want to go?
JO Huey:
If they want to know what time you are going to the Doctor,
tell them 10:00 A.M., tell them again, then say I would
love to have a cup of coffee or let's go see if the flowers
are in bloom. Anything that is interesting to them will
often work, when they come back to the original question
you can use your same answer again. They won't get tired
of the same conversation, you will, which is why you need
to find them something to do that doesn't always include
you.
This is one of the most difficult things
for the caregiver because you feel you must give them too
much information and you must get their agreement. Not unlike
a child going to school it needs to be something that is
done, it needs to be part of the routine and you MUST NOT
discuss ahead of time. When you are getting ready to go
answer in short truthful answers, "where are we going?"
"To the car?" "Right down this street? Aren't
those flowers beautiful?" "Why are we stopping
here?" "To see our friends." "I told
you I wasn't going here?" "Yes, I know, do you
want me to open the door." You just keep moving forward,
don't argue, don't lecture and don't push, just move forward
and let the staff where you are going take the lead.
<Q4>
What' the best way to intervene when someone else, someone
outside your family circle, comes and creates a situation
where your loved one feels uncomfortable? How do you avoid
embarrassing your loved one?
JO Huey:
It really depends on what they do. If it is a question such
as do you remember me? You just answer. Of course you remember
Mrs. Smith don't you mom. Regardless of what they ask you
just provide the answer in that manner. If they correct
or confront them then just politely and quickly excuse yourself.
It is o.k. to say excuse me I need to find the restroom
and mom is going to tag along with me! If it is your dad
or male spouse you can say, "I am so glad you stopped
by to chat but we must be on our way," or "we
promised to call and we are late." It is truly o.k
to tell a little white lie to save embarrassment. If your
loved one disagrees with you and wants to stay you can Apologize.
"I am so sorry mom, but I forgot to tell you that we
have to go we have an appointment." Get them away from
potentially escalating situations.
<Q5>
Is it worth trying a different approach right away, or should
we wait a few minutes? I'm talking about when a confrontation
arises, or if there's been a change in behavior that throws
us for a loop. Is it worth letting things drop and calm
down, or to just plow through on another tactic?
JO Huey: It
really depends on where you are. Apologies always work if
you can be sincere. If you are angry, and often you have
a right to be, you need to wait until you cool down. If
they are angry you need to give them a few minutes but some
people waiting makes them more angry. Try both and as you
practice you will find out what works and what doesn't.
You need to practice, practice and practice
and don't they just give you that opportunity. If you forget
and mess up just apologize and ask for forgiveness even
if you haven't done anything wrong, laugh and start over
try again. Be good to yourself and quit trying to be perfect.
I'll bet your relationship wasn't perfect before the disease?!
<Q6>
At your lecture in June, you talked a bit about bathing.
Could you review some strategies for this?
JO Huey:
Bathing is very difficult and if you already have a problem
with it you need to do it entirely differently than you
have been. This may include having someone else do it while
you are gone or having it done at day care, etc. Bathing
is very private and many people are modest even with close
family members. Focus on the task not the way it is done.
Focus on getting clean not necessarily a shower. "How
about soaking your feet, doesn't that feel good?" Hand
them a soapy washcloth when they are on the stool and suggest
they freshen up a bit. Place it where it needs to go, have
some gloves handy so you can get it out of the stool!! Start
small and work up, it needs to be pleasant, not confrontational.
<Q7>
I liked what you said about not being confrontational. If
the person doesn't stink, is it okay to try at a later time,
when the person is calmer?
JO Huey:
Even if they do stink the right time is the right time and
the wrong time will set a precedent that is hard to overcome.
If you fight about bathing you will continue to fight about
bathing - don't start and if you already have change it.
<Q8>
I was wondering what you could say about communicating with
siblings about your mutual loved one's condition, and getting
them to chip in on tasks that are particularly difficult
for you to do?
JO Huey:
Sometimes it is impossible to get family members to help.
It is often easier to ask a friend. Maybe one of their friends
can help, if they understand what is going on. You may have
to hire it done. If you couldn't get family members to do
what you asked before you had this problem then you won't
get them to do it now either.
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