Mental Health

How To Talk To Someone With Dementia

Someone with Alzheimers or another memory-related disease can still have a fulfilling life, but the onus is on you to learn new communication skills to help them.

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Three years ago, my then-86-year-old mother started to show signs of a memory issues. She missed dates, lost checks, and often couldn’t find the right word or context for what she wanted to say. Personality changes followed. A woman who had long prided herself on being well-dressed, my mother suddenly started dressing in rumpled clothes, with her hair in constant disarray.

Soon, she was diagnosed with Alzheimer’s. Eager to help my mother, we decided that the key to allowing her to age with dignity within our family while retaining her role as matriarch was to learn as many memory issue-related communication skills as we could. So we participated in a pilot study conducted by Dr. Angela Roberts at Northwestern University, learning better methods of maintaining a positive relationship with a mother with Alzheimer’s.

Those classes with Dr. Roberts made a profound impact on me and my mother. Even years after the initial diagnosis, my mother is still an integral centerpoint of our family, and our ability to adapt our communications to what works for her was the key to maintaining that relationship.

If you have a friend or family member with memory-related issues, here is some of what worked for us.

A middle-aged man poses in front of a vase with flowers with his 93-year-old mother, who has Alzheimer's.
Rick Planos and his mother, Joan.

The Onus Is On You. Clue Them In.

The first thing you need to internalize is that an Alzheimer’s patient can’t just “try harder” to communicate what they’re feeling, or remember a word, a face, or a memory. That means the onus is on you to help them, adapting your own particular communication style to their limitations.

Most people don’t do this, which is why memory care patients can frequently be treated like wallpaper at family gatherings. They struggle to answer questions that haven’t been adapted to their limitations, and because of that, others soon give up trying to bring them into their conversations.

An Alzheimer’s patient can’t just “try harder” to communicate what they’re feeling, or remember a word, a face, or a memory.

But there are skills you can learn to help a memory care patient communicate better. For example, when you ask a person with memory issues a question, you can bake in clues and questions that will help the person know how to respond. So instead of:

“Remember when we went to Portugal?”

Try:

“When I was a senior in High School, remember we went at Christmas Break on that great trip to Portugal with the entire family, and we stayed in that amazing chateau on the river?”

By verbally painting a more complete picture, you assist the loved one in possibly accessing a memory. It may feel like a leading question but offering multiple access points means there are more branches for the person to grab on to. Maybe “Portugal” doesn’t click that day, but the mental image of everyone being on the beach might.

Be Patient, And Remember Empathy

It’s easy to become frustrated when someone you love can’t remember things you did together, or even finish a sentence. But getting frustrated isn’t going to help the situation. Alzheimer’s patients, people with dementia, and other individuals with memory care issues are still human, and can become very embarrassed when they aren’t able to answer a question or recall an event… and that embarrassment can become a further impediment to communication. Imagine that moment we have all faced when we couldn’t recall a name, date or event, then multiply it by one hundred times daily and you get close to what it feels like to be a memory care patient.

It’s your job here as a caregiver to make sure that a person with memory care issues isn’t embarrassed when their condition gets the better of them.

Again, it’s your job here as a caregiver to make sure that a person with memory care issues isn’t embarrassed when their condition gets the better of them. Practice empathy to make sure you don’t accidentally emphasize their mistakes. I find it helpful to think at times what it would feel like if I was the one who could not recall. It’s like missing a step on a stairway and knowing that even if you fix that stair—find that missing word—there are more and more missed stairs ahead. Barking, yelling, demeaning only worsens the situation.

Sometimes It’s Okay To Not Talk

Another lesson I learned first-hand from my classes with Dr. RobertS was that it takes an incredible amount of energy for a memory care patient to stay engaged in a fast-moving conversation.

I can see this firsthand with my mother.  In her case, I can see that after a full day of activities at the neighborhood senior center, she’s often exhausted. During that time, it’s inconsiderate to pepper her with questions, even if I am excited to encourage her in taking part in outside activities. I can ask her questions later: what she needs first is quiet time.

Being “on” all the time attempting to keep up appearances with people outside the daily reality of memory loss is stressful. So remember: coming home for a memory care patient needs to be a safe, recharging choice, not another hurdle to try and pass after a day at the races.

A middle-aged man and his mother stand outside of a theater, ready to go see Chicago.
Thanks to the communication skills he has learned, his mother is still able to live a fulfilling life, despite Alzheimers.

Don’t Be Afraid To Change The Subject

One of the most difficult questions facing those of us who are caregivers is at what point do you answer tough questions truthfully, and when do you skirt the truth.

For example, say your mother has Alzheimer’s, and asks about your father who died ten years before. Should you tell her about his death? Many people make it a point of pride to do so, but the problem with this approach is you can’t just “correct” a memory care patient once and be done with it. If they’ve forgotten their spouse’s death once, they will do so again and again… reliving the pain every time they are told the truth.

It isn’t your job as caregiver to “correct” a patient when they forget something: it’s your job to protect their happiness, and make things as easy as possible for them.

Move past your pride, and internalize the situation. A memory care patient isn’t going to get “better.” Every patient has good days and bad, but by and large, the path goes downwards, and their life is hard enough. It isn’t your job as caregiver to “correct” a patient when they forget something: it’s your job to protect their happiness, and make things as easy as possible for them. Their life is hard enough without constantly reopening old wounds.

Conclusion

When my mother was diagnosed with Alzheimer’s, I worried about what our future would look like. The good news, though, is that by applying these techniques to our life together, I discovered it was still possible to have productive, mutually beneficial discussions. Instead of her disease driving us apart, it has brought us closer: I still learn new things about my mother’s life every week, like what dreams she had as a child, a secret motorcycle my father kept when they were teenagers, and countless other stories which I’d never have heard if I didn’t learn how to communicate with her, post-Alzheimers… and, most importantly, how to listen.

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