Communicating with Alzheimer's Patients, Maintaining Respect
I remember being told as a child, ‘It’s not what you say, it’s how you say it.” In serving as a caregiver with my mom, I find that those words especially ring true.
First of all, my mom always has been in control. As the matriarch of the family, she was pivotal in almost every major family decision – which house my parents would buy, where the family went on vacation, and what the children’s punishment would be if we misbehaved. Even as Mom has aged and succumbed to memory loss and Alzheimer’s Disease, she still gives the impression of being a feisty woman who gets what she wants when she wants it.
So the challenge has become how to get her to do what we (the nursing staff, aides and I) need her to do. I’ve learned that her reaction is directly tied to the approach of the person making the demand. For instance, one nurse’s aide would tell my mom in a very direct way what Mom must do. Needless to say, my mom’s stubborn side (she calls herself a Missouri mule) came out in force.
Yet another aide can get Mom to do anything by posing the demand as a request. For instance, this aide will ask, “Do you want to go to bed?” instead of “It’s time to go to bed.” Mom thinks about it for a moment and then calmly agrees that she is tired and ready to retire.
The nurses also have learned to ask Mom if she is ready to take her medicine. If Mom is in a bad mood and says “No,” they’ll wait awhile and then re-approach the issue. By that time, Mom’s mood has changed and she is much more willing to work with the staff. By posing their needs as requests, the nurses and aides have learned how to gain my mom’s trust and cooperation.
Even in my conversations with Mom, I’ve learned to frame comments in such a way that makes her feel she is in control. One day, the retirement home sponsored a special outdoor lunch for the residents in the secure unit. I arranged my schedule to join Mom for lunch. At the end of the lunch, I leaned over and thanked my mom for inviting me to join her for lunch (even though in reality it was my idea to come). For a moment, she looked a little startled, but then a pleased look came over her face. Taking great pride at the thought that she had invited her daughter to lunch, she warmly said, “You’re welcome.” That opportunity to give my mom’s dignity back to her (even if only for a moment) has been one of the greatest gifts I could ever give her. And the pleasure in her eyes as she responded was the best gift she could give me.
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Published On: June 21, 2006