We are pleased to feature a guest post by Ellen Woodward Potts, Co-Author, A Pocket Guide for the Alzheimer’s Caregiver. Ellen is a regular monthly blogger on Alzheimer’s disease for Maria Shriver’s website, and co-author of A Pocket Guide for the Alzheimer’s Caregiver, which the American Academy of Neurology recommends as a caregiver resource. Currently, she teaches classes on Alzheimer’s disease and on non-profit organizations at the University of Alabama, and speaks frequently to university classes, eldercare professionals, and community groups on Alzheimer’s caregiving. Ellen has a long-standing, personal interest in those with dementia, having had five close family members who suffered from either Alzheimer’s disease or vascular dementia. She currently serves on the boards of Caring Congregations, Living River: A Retreat on the Cahaba, and Habitat for Humanity – Tuscaloosa, and is an elder at First Presbyterian Church. She and her husband / co-author, Daniel C. Potts, MD, live in Tuscaloosa, AL with their two daughters, ages 12 and 16. Follow them on Facebook and Twitter!
There are several universal truths about people with Alzheimer’s disease. One of these is that they will constantly get their facts wrong. The knee-jerk reaction to this is to correct the person. “No, Daddy’s been dead for 5 years,” or “You can’t be hungry! You just had your breakfast!” or “You KNOW we’re going to the doctor today! I told you 5 minutes ago.”
Here is another universal truth of people with Alzheimer’s: They cannot come back into your world, so you have to meet them in theirs. As part of the disease process, people with Alzheimer’s disease can remember things that happened long ago, but not what happened more recently. Think of it this way: If the person’s brain is like a computer, the things they did long ago are stored on the hard drive and the person can remember these things even into the later stages of the disease, like retrieving a document you saved a year ago. However, the first part of the brain to be affected by Alzheimer’s is the part that saves current memories. It’s like the “save” button on the computer doesn’t work anymore. Therefore, it make sense that your mother with Alzheimer’s disease can remember every detail of her wedding dress from 60 years ago, but not what she had for breakfast this morning.
If you understand this, you realize that there is no point in trying to correct the person. Instead, redirect them.
“No, Mom, Dad’s been dead for 5 years.” People with Alzheimer’s may not remember that family and friends have passed away. If you remind them of the person’s death, it is like a new death to them with all the grief you would expect. Even though your mother may not remember exactly what you said later in the day, in this case that your father is dead, the feeling that something is terribly wrong will remain. Instead, say something like this: “Can you tell me the story of when you and Dad met? It’s so romantic!”
“You can’t be hungry! You just had your breakfast!” People with Alzheimer’s often forget they have eaten a meal as soon as they leave the table. My grandfather went so far as to accuse my grandmother of starving him! If your loved one tells you he’s hungry between meals, offer him cut fruit or raw vegetables. These are low in calories and high in fiber and nutrition. OR you can distract the person, “Yes, we’ll eat in a few minutes. Until then, would you help me fold these clothes?”
Arguing is pointless. Don’t correct! Redirect!
I am a huge believer in what I call “distraction phrases.” Most people with Alzheimer’s have one, if only you can find it. My father-in-law, a large and strong man, was a wanderer. Physically, there was nothing anyone could do to keep him from leaving the house if he decided to go. However, he had always been very particular about his hair. Anytime he would decide to leave, we could say, “Papa! Your hair is messed up! You should go comb it!” Every time, no matter how often it was said, he would go to the restroom to comb his hair and forget about leaving for a little while.
The mother of a friend of mine was a strong Irish Catholic. Anytime my friend wished to stop her mother’s problem behaviors, my friend would say, “Mama, will you help me say the Hail Mary?” Every time, her mother would stop whatever she was doing and pray with her daughter.
Think about what the person has always liked to do. Is he religious or was he religious in childhood? Ask him to “help you” say a memorized prayer, quote the 23rd Psalm or sing a favorite hymn with you. Was she particular about her laundry? Ask her to help you fold clothes (and always keep a basket of old clothes ready for her to fold!) Does he have a favorite song from his teens or twenties? Ask him to sing it with you. If you can find your loved one’s “distraction phrase,” it can be an invaluable tool in your caregiver journey.