Family caregivers are challenged everyday when caring for their senior with dementia – frustration, anger, tears, and refusals.
Alzheimer’s disease is the leading form of dementia, affecting as many as 5.5 million people in the United States alone.
Day to day caring can often be difficult when the progressive neurological disease worsens over time.
It has been said it’s our reaction to a person with dementia that needs to change in order to be the best caregiver possible and that caregivers need to stop expecting their senior to change. The senior with dementia is not the person they once were and won’t revert back to someone they used to be if we push them harder or wish it to be true.
Caregivers will get better results and improve the quality of their family life if they change their expectations and began communicating differently.
Better Communication for Caregivers
Here are some tips for family caregivers to better communicate with their loved ones who have dementia. These practical solutions will help you change the way you react and interact with a senior with dementia.
When family caregivers begin practicing these steps, they can reduce caregiving stress and avoid the arguments that all too often accompany families dealing with dementia.
10 Absolutes of Communicating through Alzheimer’s Disease
- Never argue, instead agree
Enter their reality by agreeing no matter what they might say. “The sky is green.” “OK. Maybe tomorrow it will be blue.” You will not win an argument against the sky is blue or that the food is too salty (when it isn’t) or that someone took his slippers (when they are at the foot of the bed).
Go with the flow.
Tell therapeutic lies if you need to in order to agree and not argue. “Yes, I see the sky is green.” Therapeutic lies may not come naturally to you but honing your skills at this great tool in your toolbox will definitely help you navigate daily challenges.
- Never reason, instead divert
Similar to arguing with a person with dementia, trying to reason with them about a particular idea they hold strongly will not end in happiness for either of you.
You won’t be able to talk them out of their belief, no matter how long you debate. It is best to change the subject or divert their attention onto something else.
They will rapidly forget what they held fast to and you can both move on to other things. Example: “I need to go home, will you take me home now?” Instead of “Mom, you are home” you should try “I understand you want to go home. How about we get you cleaned up first with a warm shower and some clean clothes before I take you home? Won’t that feel better to go home in a fresh outfit?”
After a shower it is time for a snack – – and then they may forget about going home.
- Never shame, instead distract
When you and your senior are completing a task and he/she seems to be having trouble following the steps necessary to complete it, don’t say “hurry up, can’t you go any faster, what’s wrong with you, you know how to do it!”. Instead model what they are trying to do. Untie and retie your shoe, for example. Talk through each step and have them mimic you.
If this is too difficult for them, it is best to no longer expect them to tie their shoe. Perhaps it is time to use only slip-on shoes. Otherwise, you tie their shoe for them and give them something to distract them from their shoes while you put them on, such as folding their sweater so they will be ready once you are done with their shoes.
- Never lecture, instead reassure
It is hard for family caregivers to remain calm all the time. We are tired, stressed, sad, and dejected sometimes when dealing with our senior with dementia.
Lecturing them or telling them what to do in no uncertain terms won’t help them. Reassuring them that you can do it together or they can do it or they will be safe or that you love them is important for them to hear.
They may not remember that you love them and are there to help them every day without constant reminders. Sometimes reassurance comes in the form of a hug, a smile, or a gentle touch — not just our words.
- Never say “remember,” instead reminisce
They don’t remember – remember? Asking them if they remember where they lived or what year they were born will make them frustrated or sad or depressed that they can’t remember.
It is better to say “When we visited your parents home in New Jersey, we picked those same yellow flowers. You and your mom used to love picking flowers together just like we do.”
Share their stories with them and let them fill in any details they do remember. If they make up some details, that is OK too because they are engaging with you and being in the moment matters.
- Never say “I told you,” instead repeat
People with dementia will have difficulty remembering directions or the steps to complete a task. Sequencing is a cognitive function lost early in the disease process.
Being unable to remember how to brush their teeth is frustrating for them. If they can’t remember the steps to brush their teeth even after you have reminded them it is time but don’t seem to be getting it done, using your words to badger instead of support them will only frustrate them more and may end in aggressive behavior.
Give one step at a time in the most basic directions. “Pick up the toothbrush. Put a dab of toothpaste on the brush like this. How about a little water on the paste now? Let’s just put a drop on it under the faucet. OK, now put the brush in your mouth and rub your teeth. That’s right – up and down, touch all your teeth not just the front. All done? OK spit out the paste and we’ll get a drink. Don’t forget to rinse off the brush. Put it back here in the glass so we can use it later. Doesn’t your mouth feel good?”
Having to give them this much verbal cuing for a daily task will definitely take more time from your day as you allow them to stay independent, but meaningful activity will help them and you in the long run.
- Never say “you can’t,” instead do what they can
Being negative isn’t productive and they will resist you all the more. Give them all the opportunities to be successful doing tasks that you can including setting them up with all the pieces no matter the activity.
Role modeling the task, giving verbal cues, keeping everything in their reach and praising their efforts will make these daily tasks easier.
- Never demand, instead ask or model
Show them the way. Don’t push them into doing something they no longer are capable of doing.
Abilities to complete tasks, remembering steps, making their hands move just right and even being able to stand long enough to finish something is lost as dementia and functional status declines.
- Never condescend, instead encourage
Positive reinforcement and a loving tone will lead to more success than berating them out of your own frustration. Encourage, don’t discourage.
Sometimes our body language or facial expressions do all the talking. Be aware of what your body is saying too so you don’t get resistance.
- Never force, instead reinforce
People with advancing dementia have trouble making decisions. It is best not to try to force them to come up with what they want without giving them a simple choice.
For instance, when deciding what is for lunch. Don’t just say “what do you want for lunch today” and get angry when they have no idea or they become frustrated and refuse to eat anything. It is better to say, “we will have lunch in 20 minutes. Would you like a turkey sandwich or a tuna sandwich today”?
They will be much more likely to answer that simple question and remain calm enough to actually eat it. You can prepare all the rest of the items without their input. Perhaps they can set the table with napkins while you do the sandwich making.
Praise their response to reinforce what you want from them. “That is a great choice, we both love tuna on toast. Thanks!”
Plan for Things to Take More Time
Admittedly this approach will take you more time and you will need to plan accordingly. You won’t be leaving the house in 5 minutes anymore or finishing a meal in 15 minutes. Everything will probably take longer for you both.
That is OK because what you are trying to do is facilitate their ability to do as much for themselves as they can while reducing frustration and aggressive behavior. Try to remember the adage “it isn’t them, it’s the disease”.
Caring for a person with dementia will bring new challenges each day. How you approach each new challenge will determine your success and keep you from being overwhelmed.
Understanding that you can handle the situation, communicate more clearly and have a better relationship with your senior with dementia will make your caregiving experience a little easier.
Most of us don’t choose to be caregivers, it is often thrust upon us. How you react is in your control!