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What’s the best way to communicate well with someone with Alzheimer’s?

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May 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Good communication can help many problematic situations and behaviors, and even sometimes negate them. The No. 1 tip you can learn on this topic is to treat a loved one with Alzheimer’s as an individual with a disease, not as a diseased individual. The person has an entire, personal, individualized history that will stay with him or her throughout life’s journey. Some characteristics will never leave; some will become more pronounced. A high-anxiety person could still be tightly wound, while a laid back person could become even more so. Everyone needs to have his or her feelings validated, and individuals with Alzheimer’s are no different. In fact, they might need it even more, given their likely memory loss or possible insecurity issues. Here’s an example: You mother, who has Alzheimer’s is angry with your wife a lot of the time. They were on good terms in the past, but now she blames your wife for everything. You have to keep in mind that it is the dementia talking, not your mother. You can validate her feelings by saying, “I don’t blame you for being angry” and then move on. What she feels is real to her (even if it’s not true) and you should at least afford her some validation. Of course, you might have to coach your wife at this point, too. Reinforce that the comments and action aren’t necessarily against her at a personal level. It’s the nature of this devastating illness and, in the long run, is only a temporary condition. People who have Alzheimer’s respond well to affirmation so be generous with the praise and comments such as “good job” or “way to go,” etc. Here are some other tips to conducting good communication with your loved one (or anyone) who has Alzheimer’s:
  • Identify yourself when you begin a conversation. If he says he knows already, laugh and joke it off
  • Maintain eye contact when speaking
  • Slow down when you talk
  • Use short sentences
  • Smile and be pleasant
  • Be aware of her body language. A sudden change in position (i.e. sit-to-stand) could indicate the need to go to the restroom, or another form of discomforts
  • Be aware of YOUR body language. Try not to appear tense, upset or intimidating. Remember: The majority of communication is conveyed non-verbally
  • Don’t argue
  • Ask only one question at a time. Give enough time for responses. Yes/no questions are the best
  • Don’t talk about your loved one as if she or he weren’t there — you can never be sure of just how aware she or he might be. Also, don’t be condescending or order the person around
  • Try to avoid a high-pitched tone of voice. It could be interpreted as anger
  • When your loved one is upset and communication between you just isn’t working, try a hug. Soon, anger should be forgotten and you can try again
  • Use gentle touches to get your love one’s attention if necessary. You can try by putting your hand on his shoulder, knee or hand
  • Eliminate any noise that could be distracting, such as TV or radio. Go to another room to talk if it would be helpful.
  For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”  
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How likely is it that my loved one with more lucid days and less lucid days with Alzheimer’s?

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May 11, 2012

- Alzheimer's Care, Blog, Elder Law Articles

It is very likely he or she will be just like anyone else: The person will have good days and bad days, clearer days and foggier days. Sometimes it will seem like nothing is wrong; others, there will be no doubt Alzheimer’s is at work. On a good day, the person might remember things like he or she once did. Patients might appear upbeat and say they are feeling good. You should savor these times. Such lucidity is a blessing you should embrace. You might begin to question whether the Alzheimer’s diagnosis is accurate. This would be false hope. Realize these times should be savored, for they will pass. Caregivers tend to go through a grieving process and that can lead to fantasizing. It might seem like everything is just a bad dream, or that things will go back to the way they were one day. Denial might set in. We look forward to our loved ones “snapping out of it” any day. If and when lucid days come around, they can validate such fantasies. But then reality will hit us squarely between the eyes. While you must let yourself grieve, you also must remember to enjoy each moment of the good times. It might be a few good days, or even just a few moments. Enjoy them regardless! “Quality” is more important than “quantity.” This is what you have to remind yourself. If your quality time is limited, at least you have those moments to draw from. Look at them as a blessing — and look back to them to help you get through bad times. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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Can I seriously consider being blessed to be a caregiver?

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May 10, 2012

- Alzheimer's Care, Elder Law Articles

As devastating as Alzheimer’s is, you can look at it as a burden or a blessing. We cannot control so much of our life — like what people think of us or how they run their lives. Or whether we get a disease. But what we CAN control is our own reactions. While it might be very difficult, as a caregiver you must arrive at a place of acceptance. But you do not get there without grieving first. Grieving is undeniably a personal journey. Some people progress at a fast pace while others take longer periods at various stages. Some stages they might never experience. Grieving can consist of many emotions: Shock — You can’t think, speak or react after hearing the diagnosis Emotional outpouring — Yell, cry, even throw things at this stage Depression — Loneliness and a feeling of isolation set in Physical signs of distress — You might feel ill or extremely tired Anxiety — Worries about what’s going to happen in the future grip you Anger, hostility — You’re mad at the afflicted person, your family, doctors, even God. You then can feel guilty, especially for the anger you have directed at God Guilt — Your thoughts and feelings make you feel guilty, or you feel that you’re not doing enough as a caregiver Not keeping up with normal activities — You worry about how others will react or treat your loved one Healing of memories — You come to the slow realization that healing memories are often painful memories. This is the time to come to grips with what is happening and realize that life has to change if it’s going to continue. Feed off the good memories to keep you going. Acceptance — You start to accept you are in a new chapter of life. If you can accept that, you can get on with your life, and with much less stress. Realize that you will continue to grieve due to the ongoing changes with Alzheimer’s disease. Even when you might get to the “acceptance” stage, you won’t be at the end of the line — you might cycle through the stages again, or through just a few. This is normal. It will not mean you’re regressing or going backwards. Afford yourself a break. Let yourself feel. The blessings start to become apparent once you hit the “acceptance” stage. It’s said Alzheimer’s disease can be a person’s second chance in life. Inhibitions disappear. Patients become blatantly truthful, and often funny in the process. You did not ask for your loved one to have dementia, and you didn’t ask to care for her or him. This situation has been “given” to you. That means it is a gift to you. And you discover that your loved one also is a gift to you. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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Does music help aggressive behavior in dementia patients?

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May 9, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Generally speaking, most individuals with Alzheimer’s or other forms of dementia respond well to music. Music is known as “the international language” and can be very helpful in many therapy endeavors. Of course, responses depend greatly on the individual, the Alzheimer’s stage — and sometimes even to the degree the person liked (or didn’t like) music previously. Then, there’s also the issue of what kind of music is to be played. There is a stereotype that seniors will like only “old music,” or music that was popular when they were much younger. But that is an unnecessarily narrow view. Any music from the time of their birth to the present day is “from their era.” Too often when working with people with Alzheimer’s, or seniors in general, we think too narrowly of possibilities. If you play music for a loved one with dementia and it doesn’t appear to be helping, try a different kind of music. Almost any genre of music — including classical — can feel hectic or stressed. This can over stimulate someone with weak defenses. Then, it ironically could become a case of causing more anxiety or agitation, rather than soothing it. Individuals with dementia can’t always say how they’re feeling, so the next step might be to act out. Therefore, closely monitor what is played, and what works. Music or recordings that can be described as “white noise” are often soothing to individuals with Alzheimer’s. While “white noise” machines can be purchased, just running a fan or being somewhere near a bubbling fountain also could help your loved one relax. You also can find CDs or other recordings with calming sounds of the wind, the ocean or birds, though you will want to observe whether any bird sounds become over-stimulating. If they do and start to create agitation, just turn off the recording. Just like other people, sometimes individuals with Alzheimer’s want and need silence. So when all else appears to fail, try some peace and quiet! For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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Sometimes my mother totally refuses to cooperate with me (for dressing, cleaning up, etc.). But if we call in a familiar nurse-aide, Mom’s a peach and there are no problems. What gives?

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May 3, 2012

- Alzheimer's Care, Blog, Elder Law Articles

The difference in relationships matters. Non-relatives sometimes have easier access or more cooperation precisely because they are NOT family members. Many times, loved ones are harder on their relatives than anyone else. Your mother probably feels she can act however she wants around relatives. Sometimes, loved ones don’t have good relationships to start with and this is just continuation of that dynamic. But usually a person will be on his or her best behavior for someone outside the family. That’s good news for aides, doctors and sometimes even strangers with whom they interact. Sometimes all the family contact, and familiarity it brings, is too much. You both might just need a break from one another, having spent too much time together already. This is not something you should take personally. Your mother still loves you. Just remember that she has a form of dementia. Many people don’t realize that almost all inhibition is eliminated with dementia. It’s a bit of a mystery, frankly, how some people can maintain such good manners with someone who is not as familiar with them as you. It’s important for caregivers (such as yourself) to learn to let things go. You should weigh things such as: If all she wants to eat is chocolate pudding, is it hurting anyone/anything? If she wants it for breakfast, it might not be the most nutritious thing for her, but it’s not going to harm her (unless medically contra-indicated, of course).  Learn to step back and evaluate the overall implications of odd requests or off-plan behavior. Choose your battles wisely. Often, if a loved one with Alzheimer’s doesn’t want to eat or dress or do some other common task, she or he will cooperate when you ask again later. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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If a person has Alzheimer’s disease, how important are routines for them?

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May 1, 2012

- Alzheimer's Care, Blog, Elder Law Articles

This is a very good question because routines are very, very important. A steady routine will be familiar and comforting as a person with Alzheimer’s progresses into the disease and loses more memory. If you live with your loved one, make everything a part of a schedule or routine if possible. You should do this for both of your sakes.   Rituals, such as at bedtime, are critical. If your loved one always ate something particular before bed, or checked a door(s) or performed some other task, you should continue with it. If your loved one becomes restless before bed time or is having a hard time getting to sleep, allow him or her to get up and do anything in their ritual. This will help the person feel at home. To reiterate rituals and routines are very, very important.  A daytime routine might include specific medication or eating times, checking the mail, bathing, going to get a haircut, grocery shopping with you and just about anything else you want to include. Putting drinking water into the routine is great because it can add to a sense of process but also keep a person with Alzheimer’s hydrated, which can sometimes be an elusive task. You both should also be sure to include relaxation time in your regular schedules. Some other good things to include in a daily schedule could be: feeding a pet(s), folding laundry, reading the newspaper, going for a walk or drive, taking out the garbage, getting a snack, drinking coffee, etc.  It might be difficult, but while trying to keep a steady routine, you have to avoid becoming too rigid. If the activity you had planned isn’t working out well for your loved one, be flexible and don’t argue. Move on to the next thing and go with the flow. If you have an activity that simply must be done (such as dressing), take a break from it and try again late. For more information, click here to receive our FREE “Indispensable Alzheimer’s Resource Kit, ” which has additional information regarding caregiving issues.  In addition, attend an Alzheimer’s Support Group.  To find one in your area click here. 
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As the primary caregiver for somebody with Alzheimer’s, should I journal my thoughts?

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April 24, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Absolutely. Keeping a journal is a good idea for everyone — especially someone with a stressful and emotional burden such as caregiving. Journaling means putting your thoughts on paper and keeping them between you and the paper. Keep the journal in a secure place if you’re worried about someone else reading it. Just don’t forget where it is so you don’t write in it!  Actually take time to schedule journaling into your routine. You don’t have to find time every day, but you should make a point of doing it regularly.  Journaling is to the brain and emotions what physical exercise is to the body. You don’t have to write a lot, just enough to get things out and off your chest.  Write about your thoughts and feelings. Write of your anger, resentment, fear, guilt and any other strong emotions. You can even make this a practice of “writing to the disease.” Go ahead and tell it how it is upending your and your loved one’s lives. Let it know you hate it. Tell it that it is messing up your retirement years after so many years of hard work and planning. This is a good way of dealing with your feelings. It is healthy to do so.  Your journal also can reflect your observations about your loved one. Include notes on patterns that might emerge regarding behavior, eating, sleeping, toileting, etc. This will help when you talk with the doctor. It also can help you reflect on the way you handled certain situations.  Journaling is a good way to help you sort out your thoughts — on many levels. If you’re feeling overwhelmed, it can help pull things back into perspective. It is important, however, not to allow journaling to be your only outlet or release. Human interaction is still very important. You must continue talking with friends and other members of your family. A support group might also be a good idea. Everybody needs human contact and socialization to re-energize. In fact, The FREE Indispensable Alzheimer’s Kit includes a Caregiver’s Journal specifically for this purpose.  Click here to download it now.   
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What kind of activities do you suggest for me and my husband (who has Alzheimer’s) at home?

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April 23, 2012

- Alzheimer's Care, Blog, Elder Law Articles

If you step back and take a good look, there are many options for you. Just about anything you do together can be viewed as an “activity.” It often doesn’t take too much to make a person with Alzheimer’s feel useful. You can do something as helpful as go grocery shopping. Have him push the cart, or hand him things to arrange in the cart. He also can help unload them for the cashier and then later load them into the car. Having him hold a bag while you’re unlocking the car or your front door also can build self-esteem. Here is a list of activities you might like to try at home. Mix and modify as you find useful. You will have to consider cognitive ability and functioning levels, of course, so you don’t attempt something that will prove too hard or frustrating. Some of these things can be done with a partner, or alone. As time wears on, he will need a partner more often. With Alzheimer’s patients, it is always important to have a routine or schedule to rely on. Just don’t adhere to it too strictly if you see your husband’s mood or disposition is not suited for what you think you should be doing. • Play music — Music can enhance memory. Play upbeat music you can dance to, if that is a desirable option. It’s good exercise. Calming music will help everyone relax. • Write his life story with his assistance — Help him remember his life as you both organize photos and story lines. Include special events, family, awards, special events, accomplishments and more. Put everything in a durable book that your husband can carry around and look at often. • Video break — There are numerous videos/discs designed specifically for people with Alzheimer’s in mind. For example, Innovative Caregiving Resources (http://www.videorespite.com/) has 10 interactive DVDs/videotapes that will typically keep the attention of a person with Alzheimer’s for their full duration (20 to 53 minutes). Visit the company online, by phone [(801) 272-9446] or by mail: P.O. Box 17332, Salt lake City, UT  84117. • Exercise — Join a gym (to help both of you), go on walks, use an exercise video or audio program, putt on a portable putting green, bat an inflated balloon back and forth, play suitable games such as horseshoes (soft ones are lighter), bean bags or croquet. Your imagination is the only limit here. • Play cards or board games such as checkers • Relaxation — Have a relaxation period each day after lunch. Burn candles or incense (remember which scents get the best reactions), play calming music, gently massage warm lotion onto hands or arms. Consider this type of ritual around bedtime, too. • Read enjoyable things — This could be something funny, inspirational, spiritual or just reflective. One person can read to the other, or you can read together. For more information, an excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.  
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How do we not upset Mom’s routines if we hire an in-home helper?

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April 19, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Narrow your candidates down to two or three and then invite them into your mother’s house to observe them interacting with her. This should be very enlightening and help you trim the choices further. Look for someone who is kind and attentive. Other things can be taught, such as where things are and where they belong, how routines are run and tips on how your mother likes baths, food, dressing, etc. But if a good spirit and healthy interaction aren’t there between two people, that’s hard to overcome. It’s very hard to force after the fact. Involve your mother as much as possible in the selection process. Even if she has late-stage Alzheimer’s, she can tell you in her own way what she thinks about the candidates. It might be through a gesture such as a wrinkled up nose or a thumbs-up or -down. Or she might resist giving an opinion at all. This is not insurmountable. If she does not consciously want to help you through the selection process, observe her body language around the candidates. How does she respond to each? Once you have hired a helper, bring her or him in one day before the official start of work. Give this person plenty of time together with your mother so they can bond and get to know each other better. By all means, let your mother know what is happening, and that this person is going to be with her for long periods. Be firm but sympathetic. Tell the hired caregiver about your mother’s likes and dislikes with regard to food, activities and other situations. The better the caregiver and your mother know one another, the better the care will be. Some people like to start a new caregiver with just a few hours of work the first day. This helps let your mother know her world has not been suddenly 100% turned upside down. You should keep a good, professional relationship with the caregiver. Encourage this person to call you with information — good or bad — about your mother. Constantly check with your mother on how things are going. Let her express her feelings. If she is unable or unwilling to tell you anything, you still can learn a lot simply by observing her body language. This is vital for determining whether you should keep a current caregiver or move on to another one. For more information, an excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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How do I deal with my sometimes-explosive outbursts at my mother?

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April 18, 2012

- Blog, Elder Law Articles

Anger is a common emotion when caring for a loved one, especially if she or he has Alzheimer’s. When you see someone you knew as being independent and who was likely somebody you looked up to now having difficulty with simple things, it can be very difficult. Your loved one might not be able to understand much of what is being said to her. She also likely has forgotten many treasured (and helpful) memories. Why wouldn’t you be angry? You are losing a little part of this person, day by day. You are grieving, which naturally can lead to anger. If your yelling occurs only occasionally, you’re may have to own up to the fact that you’re simply going to lose your temper every now and then and yell. If and when it happens, practice letting go of any guilt you feel. Give yourself a break: You are human. Yelling isn’t good, but it happens. This also might be a sign that you need a break from delivering so much direct care for your mother. Taking her to an adult day care center will give her something to do — and give you a break for a while. Or you can hire someone to come into the home so you can go do something on your own. Take advantage of other family members, friends, neighbors and volunteers who might offer to give you a break. You can also find relief by joining a support group or finding a suitable counselor. Knowing that you are not alone in these types of situations usually decreases the pressure you feel. You can also collect some tools to help you cope. If you find the yelling becoming more frequent, you might end up having to find other arrangements for your mother’s care. Quality time with her is more important than quantity time. If your time together is only stressful and becomes consumed by more and more yelling, it is time to make a change. This could mean a group home, nursing home or assisted living situation. Then when the two of you visit together, you might truly enjoy it more. It could be a healthy move for both of you. You shouldn’t feel guilty about having her live in a facility, if you go that route. You can still be very involved in her life, and help manage her care (in coordination with the facility). This can lead to more enjoyable time together. This might entail taking her out to a nearby park, a nice restaurant or even your home. You can have fun together. For more information, an excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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