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How To Communicate With An Alzheimer's Patient
By: William G. Hammond, JD, and Jea Castrop May
Author of The Alzheimer's Legal Survival Guide and The Alzheimer's Resource Kit"
Much of the frustration and anger a person with Alzheimer's disease feels stems from difficulty with communication. Many times they can no longer express what they would like, such as needs or feelings and cannot receive or interpret information as they once could. When communicating with your loved one, allow them a significant amount of time to process the information and then time to respond to the information. We may think the person is having difficulty hearing, when in fact, they are processing the information more slowly and may need adequate time to respond.
One very successful form of communicating with a person with Alzheimer's disease is through validation. All people want their feelings validated, the person with AD is no different. Actually, they need more due to their memory loss and feelings of insecurity. Feelings are very real to them and if they are shunned and not validated, it can lead to frustration, anger and possible outbursts. Validation lets a person know they are being heard, hopefully reducing episodes of frustration and anger.
Validating someone's feelings does not necessarily mean you agree with them, it means you have heard and acknowledged what they are feeling.
For example, your loved one is asking for their parents who have been deceased for many years. You need to try to look beyond the question and determine what they are feeling; lonely, sad, abandoned or are they grieving because they miss them?
A good general response would be, "I have always loved your parents, what is your favorite memory of them? Or "Remember the great pot roast your mom cooked?"
This validates they are thinking about their parents and allows them the opportunity to reminisce. Reminiscing is very calming to them and helps with feeling secure about "who" they are. It also aides in the transition from the intense feelings to feeling more at ease. Another example: "I'm so stupid, I just can't think like I used to." Answer: "Honey, I know you are feeling angry and frustrated. I get frustrated too when I forget things. We're going to have to help each other." You have validated the feeling and at the same time have calmed them by acknowledging the feeling, and then offered support. Validating their feelings is crucial to their self-esteem!
The idea of validation of feelings deals with the feeling(s) at that moment. With short term memory loss, we have to focus on the moment at hand. The old school of thought was "reality orientation" or always bringing them back to the present. This concept can still apply depending on the individual person and their level of orientation and memory.
For instance, if your loved one was asking about their parents and you responded "Oh honey, you know they have been dead now for over 20 years, they're buried in St. Andrews cemetery just outside of your hometown." This one statement could bring up many questions such as "My parents are dead?" "How did they die?" "Why can't I remember they died?" "Aren't we still living in my hometown?" In turn that can lead to feelings such as abandonment, anger, frustration, loneliness, sadness, and so on.
As you can see, this response can cause anxiety and maybe even panic. Allowing them to stay in the moment and not orienting them to reality, is not only okay but almost necessary for their emotional well-being. Many times trying to orient them to reality will cause confrontation, making them defensive and wanting to "lash out." As they say, "Just go with the flow."
As a caregiver, your goal is to communicate in a way that will not upset or cause your loved one to become anxious or agitated. You want them to feel as safe and secure with this situation as possible. Good communication will not only help your loved one, but may make your role as caregiver less stressful and more rewarding.
Copyright, 2000-2004 The Alzheimer's Resource Center, Inc. All rights reserved.
My good friend and Elder Law Attorney William Hammond founded The Elder & Disability Law Firm in 1996, as he puts it, "out of necessity." Hammond's mother-in-law fell and broke her hip the previous year and Bill and his wife Mary became her primary caregivers. The law firm grew out of his frustration in trying to track down the answers to legal questions that he was now facing on a daily basis. Bill decided that the answers to the questions he and his wife were facing needed to be more available to the public and so the firm was founded.
Today The Elder & Disability Law Firm serves clients all over the states of Kansas and Missouri. It's not unusual to have people drive in from several hours away to meet with the staff and attorneys of the firm and to get help with their most pressing elder law issues.
Almost from the first day that the firm opened its doors, the families who have a loved one with Alzheimer's have been flocking to the firm. Over and over again issues of caring for a loved one with Alzheimer's have been raised. Over the years the attorneys and staff at the law firm have developed a real expertise in helping people suffering from memory loss. That in turn lead to the establishment of the Alzheimer's Resource Center.
The Alzheimer's Resource Center is dedicated to helping families throughout the U.S. understand better how to care for and plan for their loved one who has Alzheimer's Disease. The Resource Center is dedicated to helping families learn more about the disease and, more importantly, learn specific strategies that the families can use to reduce caregiver and Alzheimer's patient stress and keep the loved one at home as long as possible.
To this end the firm offers its Alzheimer's Survival Kit "the standard of information for the industry" as well as frequent Telecoaching Seminars teaching families the "hands-on" skills they need to learn to better care for their loved one.