Caring Through Communication
Data from a 2017 Alzheimer’s Association report says that in people age 65 and over, one in ten has Alzheimer’s dementia. That equates to 5.5 million people are suffering in this dementia stage of Alzheimer’s disease. When a parent is diagnosed with dementia it’s important to remember exactly that: it’s a disease. “Dementia affects brain tissue, and that can cause personality changes,” says Dr. Diana Kerwin, certified geriatric practitioner and founder of Texas Alzheimer’s and Memory Disorders. So, we need to develop new ways of communicating with our loved ones to adapt to those changes.
Here are some suggestions for healthy communication.
Maintaining eye contact when talking to your parent is not only a sign of respect, it is a nonverbal cue that tells your parent they have your full attention and you are listening. Dr. Kerwin makes a point of kneeling for her patients who are sitting or in a wheelchair. By getting down to their level you create a more comfortable and open atmosphere, she suggests.
Speaking in figures of speech, clichés or using slang causes confusion. As dementia progresses, interpreting abstract concepts gets harder. Talk in short sentences using simple, straightforward vocabulary. Pause for a moment between sentences. Although this may feel uncomfortable at first, it allows your loved one to process what you’ve said.
The best virtue when dealing with communication difficulties and dementia is patience. If your parent is having trouble understanding what you’re saying, don’t continue repeating the same thing. Rephrase your sentence or break it down into smaller pieces. Reduce the tension that can develop on both sides by preparing yourself for a peaceful, easy discussion.
It’s often tempting to speak as if you’re talking to a child or to use “baby talk.” Don’t make the mistake of thinking a parent with dementia doesn’t understand what you’re saying. They need more time to process. Talking down appears condescending which often causes feelings of indignation or resentment. This is one of the reasons many dementia patients act out.
Try speaking at a slower than normal pace while using normal language. It can make all the difference.
Agree to Disagree
Arguing with a person who has dementia is pointless. Their current reality is the world they live in and trying to convince them otherwise is both futile and aggravating for you both. “Respecting the autonomy of the person with dementia is important,” explains Kerwin.
In some instances, arguing with a person’s perceived reality borders on cruelty. Take for example the Mom who asks when her husband will be home from work. Each time she is told “Dad died 7 years ago,” is like hearing it for the first time. She relives the grief of losing her spouse. Although she forgets about her husband an hour later, the feelings of sadness stick around.
Go Along for the Ride
Some experts call it therapeutic validation, others “fib therapy.” They share the same goal: Allow the person with dementia to enjoy the time they have left. As Dr. Kerwin suggested, if there is no threat to the safety of the individual or their caregivers, there’s no harm in allowing a parent with dementia to enjoy their individual reality.
When his daughter decided her father needed the 24-hour care available in an Assisted Living community, Henry believed he was going for an extended stay at a hotel. (Henry spent a lot of time traveling during his career.) Several days before arriving, Henry became excited about meeting the other “hotel guests.” His transition to the new environment was without incident, and he fit in easily with the other residents. The staff never challenged Henry’s beliefs. In fact, to make Henry’s stay more comfortable he enjoys “Continental Breakfast” and receives nightly “turn-down service.” To this day, Henry has shown no desire to check-out.
The changes associated with a brain affected by dementia may reshape the way your parent communicates, but that doesn’t mean you can’t have meaningful conversations. Dr. Kerwin offers hope: “There’s always something we can do to improve the situation of a patient if we just pay attention.”