It can be challenging, at times, attempting to have some sort of intelligible conversation with Mom. She really does try, though, to keep the conversation going - but it’s exhausting, for her and for her visitor(s).
Many was the time I would ask if someone had visited - the response was generally, “No,” but I had known they’d come. So, I began asking, “What did you and (visitor’s name here) do or talk about yesterday?” This still could come with nothing, but it could also get those wheels turning. The next attempt could be: “Did (visitor) mention (topic you know they discussed)?” This has also worked.
According to The Alzheimer’s Association, the more specific you can be, the better for the patient - it helps trigger the memory, which they discovered has not been erased, rather put into another location, and could still be accessed.
Following are more tips on communicating with the patient, from The Alzheimer’s Association website:
Be patient and supportive.
Let the person know you're listening and trying to understand. Show the person that you care about what he or she is saying and be careful not to interrupt.
Offer comfort and reassurance.
If he or she is having trouble communicating, let the person know that it's okay. Encourage the person to continue to explain his or her thoughts.
Avoid criticizing or correcting.
Don't tell the person what he or she is saying is incorrect. Instead, listen and try to find the meaning in what is being said. Repeat what was said if it helps to clarify the thought.
Avoid arguing.
If the person says something you don't agree with, let it be. Arguing usually only makes things worse — often heightening the level of agitation for the person with dementia.
Offer a guess.
If the person uses the wrong word or cannot find a word, try guessing the right one. If you understand what the person means, you may not need to give the correct word. Be careful not to cause unnecessary frustration.
Encourage unspoken communication.
If you don't understand what is being said, ask the person to point or gesture.
Limit distractions.
Find a place that's quiet.The surroundings should support the person's ability to focus on his or her thoughts.
Focus on feelings, not facts.
Sometimes the emotions being expressed are more important than what is being said. Look for the feelings behind the words. At times, tone of voice and other actions may provide clues.
Going further, the successful caregivers know the following are also true:
- Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts stronger than your words. Set a positive mood by speaking to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice and physical touch to help convey your message and show your feelings of affection.
Get the person’s attention. Limit distractions and noise—turn off the radio or TV, close the curtains or shut the door, or move to quieter surroundings. Before speaking, make sure you have her attention; address her by name, identify yourself by name and relation, and use nonverbal cues and touch to help keep her focused. If she is seated, get down to her level and maintain eye contact.- State your message clearly. Use simple words and sentences. Speak slowly, distinctly and in a reassuring tone. Refrain from raising your voice higher or louder; instead, pitch your voice lower. If she doesn’t understand the first time, use the same wording to repeat your message or question. If she still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns or abbreviations.
- Ask simple, answerable questions. Ask one question at a time; those with yes or no answers work best. Refrain from asking open-ended questions or giving too many choices. For example, ask, “Would you like to wear your white shirt or your blue shirt?” Better still, show her the choices—visual prompts and cues also help clarify your question and can guide her response.
- Listen with your ears, eyes and heart. Be patient in waiting for your loved one’s reply. If she is struggling for an answer, it’s okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.
- Break down activities into a series of steps. This makes many tasks much more manageable. You can encourage your loved one to do what he can, gently remind him of steps he tends to forget, and assist with steps he’s no longer able to accomplish on his own. Using visual cues, such as showing him with your hand where to place the dinner plate, can be very helpful.
- When the going gets tough, distract and redirect. When your loved one becomes upset, try changing the subject or the environment. For example, ask him for help or suggest going for a walk. It is important to connect with the person on a feeling level, before you redirect. You might say, “I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”
- Respond with affection and reassurance. People with dementia often feel confused, anxious and unsure of themselves. Further, they often get reality confused and may recall things that never really occurred. Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real) and respond with verbal and physical expressions of comfort, support and reassurance. Sometimes holding hands, touching, hugging and praise will get the person to respond when all else fails.
- Remember the good old days. Remembering the past is often a soothing and affirming activity. Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier. Therefore, avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch. Instead, try asking general questions about the person’s distant past—this information is more likely to be retained.
- Maintain your sense of humor. Use humor whenever possible, though not at the person's expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.
Luckily, I have learned most of these steps, but there are times when it is difficult - don’t fault yourself, just remember to breathe, and know your presence does mean a great deal - even if no words are spoken. Holding a hand, sitting close and reading, helping do a puzzle, helping with something (anything), can mean the world psychically.
While it’s not the easiest way to visit, the above steps do give a path to avoid frustration and stress for both patient and visitor.
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