Written by Amy Small, LICSW
As our population ages,
the number of adults struggling with diseases of the older years increases as
well. One such disease is Alzheimer’s
Disease. The chances that we will come
into contact with someone who is struggling with this disease are, unfortunately, steadily increasing.
When we do come into
contact with someone struggling with this disease, it can be difficult to know
how to connect with them. The types of
conversations we had previously may no longer be possible due to changes in
memory or information processing abilities.
If you are a caregiver for someone with Alzheimer’s Disease, that can
bring communication challenges to the forefront of your everyday lives, greatly
impacting your relationship with your loved one. In this article, I’d like to give an overview
of some communication strategies and tips to support you in connecting with
people struggling with Alzheimer’s Disease in the community or in your own
life. For further information, I
recommend the Alzheimer’s Association website at www.alz.org.
It is important to
remember that, while the ability of a person with Alzheimer’s Diseaseto communicate is greatly impacted, they maintain their
sense of self throughout their experience with the disease. Their ability to express themselves through
language and to understand language may change, but you can still connect to
the essence of who they are.
Alzheimer’s
Disease affects each person differently.
In the early stages, it may shift the person’s ability to communicate
and they may have troubling finding the word they want to express. It can be helpful to ask whether they want to
be helped with words or not, for example, “How would you like to be helped with
words? Would you rather I jump in with a
word that you may be looking for, or wait and allow some time for you to find
it on your own?”1 While it can
help to use short sentences to aid in communication, it is important to not
“talk down” to the person. 1 Make sure to include them in the conversation
and speak directly with them even if their language seems limited. Their ability to understand may be more
intact than their ability to express themselves. 2 Communication challenges and
worries about making mistakes may lead a person with Alzheimer’s Disease to
withdraw from conversations. Including
them and being sensitive to these feelings can help them engage and feel
connected to you.
As
the disease progresses, the person may have further problems with language such
as increased difficulties finding words, repeating familiar words, inventing
words, losing their train of thought, and difficulties following conversations. 1 Connecting through ways other
than language becomes more and more important.
Paying attention to your tone of voice, facial expression, and body
language help support the feeling of safety and connection in a conversation. 1 While a person with Alzheimer’s
may struggle to understand your words, they will understand the feeling behind
your words. Your frustration and tension
will come through just as will your patience and presence. Taking your time in conversations and taking
care to notice your own emotions will support a meaningful connection.
The
person struggling with Alzheimer’s Disease may also communicate more through
behaviors or gestures. It can become
important to respond to the emotions that seem to be expressed through the
behavior rather than the behavior itself. 1 This can require you to understand and join
their reality in that moment. The facts
are less important than the feelings.
For example, rather than “Calm down, I am sure your keys aren’t really
lost”, you might say “I hear how upset you are about the keys not being where
they usually are. It is so frustrating
when that happens! Can I look for them?” 1 This type of attention takes
patience and insight. Give yourself time
and self-care to be able to provide this type of listening and response.
Some other tools that
can support a feeling of safety in communication are approaching the person
gently, from the front, and at eye level, as well as calling them by name and
identifying yourself and your relationship to them. 1 Gentle touch can also feel
grounding and caring. As processing
information becomes more difficult, it can be helpful to utilize questions that
offer choices rather than open ended questions such as “Would you like tea or
water?” rather than “What would you like to drink?”. 1
In
later stages of the disease, communicating in ways other than language may
become primary. Using our five senses
together can support connection, such as listening to music, looking at
photographs, spending time outdoors, and noticing smells, tastes, or sensations
together. 1 The most
important thing to remember at any stage of the disease is that it is okay if
you don’t know what to do or say. 1 Your reassuring presence, respect, and caring
connection are the most important to anyone in your life, including your friend
or family member struggling with Alzheimer’s Disease.
Rose Murrin,
LICSW, is the Kesher social worker at the synagogue. Kesher is the
congregational outreach program of Jewish Family Service of Rhode Island,
funded by the Jewish Alliance of Greater Rhode Island, and currently active at
Congregation Agudas Achim, Temple Torat Yisrael, Temple Emanu-El, Temple Sinai and Congregation Beth Sholom. Rose may
be reached at rose@jfsri.org or 401-331-1244.
2Coste, J. K. (2004). Learning to speak Alzheimers: A groundbreaking approach
for everyone dealing with the disease. Milsons Point, N.S.W.: Transworld Publishing.
