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If someone you know or care about has been diagnosed with Alzheimer’s, you are probably already preparing for the ways your relationship will change. Alzheimer’s disease, as defined by Psychology Today, is a progressive, neurocognitive disease characterized by memory loss, language deterioration, impaired ability to mentally manipulate visual information, poor judgment, confusion, restlessness, and mood swings. It is the leading cause of dementia in the elderly.
With these symptoms impacting your relationship with the person afflicted, you will benefit to know how to best communicate with someone who has Alzheimer’s.
Effects on Communication at Different Stages
The stage at which someone’s illness has progressed may impact your best tactic for communication. Alzheimer’s disease facts outline the stages by which communication is affected.
In the early onset of the disease, the person may find it difficult to say the right words and will use familiar words repeatedly, even describing objects because they cannot recall the words they aim to speak. Speech challenge progressions will include losing train of thought easily and difficulty forming a coherent sentence.
If the patient is multi-lingual, they may also start speaking their birth language. An Alzheimer’s disease fact is that the patient may speak less often and rely on gestures instead of speech. One of the perplexing attributes of the disease is how differently it affects each person.
In most early stage patients with Alzheimer’s, they will have the ability to communicate with others. You should make every attempt to maintain conversation, just with more patience. Still look at your friend or family member directly and in the eye when speaking to them, and wait for their response. Try to refrain from jumping in while they are talking as they may take longer to form and articulate their thought and you could throw off their answer. Make your conversation reciprocal, asking questions to continue the dialogue.
As their Alzheimer’s disease progresses, it is possible that with the aforementioned changes in speech, their stories may present as incoherent or unlikely to be realistic. It is still best that you help them to continue the conversation. Don’t be argumentative, even if you know the story they are sharing isn’t theirs, they are calling you by the wrong name, or other common communication challenges.
Alzheimer’s disease facts outline that the patient may develop delusions (false beliefs despite a lack of evidence of truth) and hallucinations (like a waking dream without outward stimuli) in their current or recall. Caring.com outlines that the patient doesn’t realize that the memories or stories they are sharing aren’t true. They are not lying, they are victim to the effects of their disease.
Ask How the Person Prefers to Communicate
The experts at Alzheimers.org suggest learning how the patient prefers to communicate. As they may themselves grow frustrated with the challenges of speech, they may prefer to talk over the phone rather than in person, or be most at ease communicating via text or email.
It is beneficial to the patient to continue to communicate in any form. By trying to speak, recall words and stories, their brains are remaining active.
Triumphs in speech can also have a positive emotional response for the patient. Reports have shown that remaining socially and cognitively active may help build the cognitive reserve of a patient with Alzheimer’s. While it cannot cure or reverse the effects of Alzheimer’s, it can help to reduce depression, apathy, sleeplessness and other side effects such as challenges swallowing.
It may be difficult for you to watch your friend or loved one change through the disease, but your presence and efforts are essential to their treatment and care.
Keep Questions and Task Instructions Simple
In opening dialogue with an Alzheimer’s patient, it may be helpful to ask simple yes or no questions. By removing the more complicated open-ended thoughts, the patient may be more at ease in evaluating the question and associating their answer.
So rather than asking, “What would you like for a snack?” ask a series of questions and be patient for each answer. For example, “Would you like a snack?” To a yes, you might follow by asking – even showing – the options, “Would you like a piece of cheese?” If the answer is no, offer and show another option.
This slower step-by-step thought process can help in communicating. If physical examples aren’t on hand such as you’re ordering or going to another location to pick up food, you can try to write down options, or use flash cards.
Likewise, if providing task instructions, offer steps slowly and articulately, one at a time. Saying to a patient that it is “time to go” could lead to confusion or lack of direction. Instead, taking them through the task list can lead to results and understanding.
Ask if they have their shoes on? If they don’t, talk them through locating and putting on their shoes. Do they have a sweater or coat? Do they have their keys, wallet or purse? The same mental checklist that you might go through before preparing to leave or a similar task list will be helpful to an Alzheimer’s patient when presented slowly, clearly, and patiently.
In the mid- and late-stages of Alzheimer’s, a patient may need your further reassurances. It is likely that to engage you will need to reintroduce yourself upon each visit, even when speaking to a close relative or lifelong friend. Be patient but respectful – remember, it’s the disease and out of their control. Maintain eye contact after your re-introduction and assist in communication with verbal and visual clues. You may also need to engage all senses – sight, sound, touch, taste and/or smell, to be sure they are understanding you.
As it is an incurable, progressive disease, Alzheimer’s disease facts state that it will become more challenging to communicate with a patient. Even as you ask shorter yes/no questions, use visual aids and other clues, responses to questions or stories shared may be harder to understand. Try to listen to the sentiment of what the patient is telling you, not only the words.
It’s possible that they will mix up words but the context of their story is where you can engage. Or you can read their happiness, sadness, or other emotions. Sometimes, a caregiver who is with the patient regularly can also help you to communicate. And most of all, being there to lend your continued support and care are what is most important to helping them through this difficult disease.