Acceptance of Change Important in Alzheimer’s Caregiving

  • My dad went into surgery with a smile and hope. He came out with severe dementia. Something unexplainable at the time had happened and Dad became a statistic – one of those “poor outcomes” we hear about. My head knew this tragedy was permanent, but my heart wanted my “real” dad back. The kind, loving, intelligent man whose love for me was steadfast. I wanted him back. Unfortunately, my family and I had to learn to accept the fact that Dad would never be the same.


    While my Dad's dementia was instant, most dementias develop over time. Yet, the end result is the same. The people who love them are forced to accept tremendous, agonizing change. That’s a hard assignment for most people, nearly impossible for others.

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    Dr. Jacobo Mintzer, chairman of the Medical and Scientific Advisory Board for the Alzheimer's Foundation of America, was recently interviewed on the website HealthDay.  Mintzer said that the “biggest initial problem for caregivers is often that they're trying to preserve the person they knew as long as possible.”


    Dr. Mintzer, who's also a physician at the Ralph H. Johnson VA Medical Center in Charleston, S.C.,  stated in his interview that, “Not pushing someone with Alzheimer's to be who they used to be makes some caregivers feel like they've given up on their loved one.”


    I was fortunate in that my instincts told me that joining Dad in his altered world to the extent that I could was not giving up on him. It was the only way to help him. Yet my mother – understandably since she’d been married to the love of her life for over five decades – did have a hard time not pushing him to “snap out of it” and act the way he used to.  Mom hated for others to see evidence of Dad’s dementia which had taken away much of his natural dignity and reserve. She took the changes in Dad personally and was embarrassed for both of them.


    Many families determinedly say, “We’re not giving up on him!” They feel that by dragging the person back into what they view as the “real” world is the only way to stand up to this devastating disease. They feel that they must fight to win. The problem with that approach is that in the end this approach will only cause frustration for both parties. For now, at least, dementia always wins the war if not that particular battle.


    The best “drugs” available may be acceptance and compassion

    Recently, I wrote about a study done by Utah State University showing that when caregivers employed  higher levels of positive coping strategies when caring for a person with Alzheimer’s disease, the care receivers declined more slowly than people whose caregivers used negative coping strategies. This group of researchers listed negative coping strategies as avoidance, blaming self, blaming others or wishful thinking. The results were measured by the Mini-Mental State Exams. This exam is a global measure of cognitive ability that assesses orientation, attention, memory, language and visuospatial ability.


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    Dr. Mintzer seems to engage the same philosophy, only in a patient setting rather than a clinical study. "We need to see ourselves as a therapeutic agent…Patients have needs…Sit down and talk with them for five minutes every hour…Talk with them in a non-threatening manner,” Mintzer says. “Share a meal, or even sit down and split a cookie. It may not meet your needs for a social interaction, but that's not the purpose of it."


    Other tips that experts suggest are that you stick to a routine, as doing so is likely to help the person feel more calm and secure. Also, a soothing, calm voice is important. Tone of voice and body language both make a difference to someone with dementia.


    Using diversionary tactics also is one of the tenents of giving care to someone with dementia, however respect should be central to all care. Answering a repeated question once and then diverting the person’s attention to something else, say some photos on the wall – preferably old ones that may be remembered – can help both the caregiver and care receiver get through the day with more cheer. Diversionary tactics, and even “therapeutic fibs,” are not demeaning to the person with dementia if these techniques stem from a compassionate heart.


    Acceptance takes time, so don’t expect yourself to respond perfectly to the exceptional challenges of caring for someone with dementia. Practicing patience and compassion, however, may lead to eventual acceptance of how your loved one is today. It’s likely that you will both have more serene lives once you, as the caregiver, can truly accept that your loved one cannot be “fixed.” Loving people as they are rather than wishing them to be otherwise is not always easy, but in the end, acceptance can lead to some semblance of peace.


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    Gordon, S. (2013, February 22) For Alzheimer's Caregivers, Patience and Compassion Are Key. HealthDay. Retrieved from


    Utah State University. (2013, January 8) Caregiver Coping Strategies Predict Cognitive and Functional Decline in Dementia: The Cache County Dementia Progression Study. Published in the January 2013 issue of The American Journal of Geriatric Psychiatry.

    The American Journal of Geriatric Psychiatry, Volume 21, Issue 1 , Pages 57-66 , January 2013 Caregiver Coping Strategies Predict Cognitive and Functional Decline in Dementia: The Cache County Dementia Progression Study. Retrieved from

    Emling, S. (2013, January 9) Alzheimer's Research: Finally, Is There Some Good News? Huffington Post. Retrieved from


Published On: February 28, 2013