How To Cope With Someone With Alzheimer’s

Coping Strategies For Alzheimer’s Disease Caregivers

If you are a caregiver for someone suffering from Alzheimer’s disease , you may face difficult challenges as you try to provide care and understand the behavior changes of the person you are caring for. Understanding the behavior of a person with AD can help lessen these difficulties.

People with AD may exhibit the following behaviors:

• Extreme anxiety about daily life, which may be exhibited by asking questions and repeating information about once familiar events and/or people, preparing for appointments/day care well ahead of time and using notes and reminders endlessly.
• Apathy or a lack of initiative about tasks that used to be routine, though now feel overwhelming. For example, the person who always enjoyed puzzles but no longer does them because they are too overwhelming and require skills he/she no longer possesses.
• Frequent agitation may occur as people become less able to interpret their environment and control or express their feelings. For example, a person with AD may strike out at a caregiver.

Dont Say No Dont Or Cant

One of the biggest mistakes in dealing with patients and/or loved ones with memory loss is being negative and telling them that they cant do something. Words like no,” don’t, or can’t create resistance. This comes up regularly with family members when the patient and/or loved one might be still driving, and the caregiver and/or family member has made the decision to stop them from driving. One should never say, You can’t drive anymore. They can still technically drive , and they can get very combative when told no. A way to counter this is to say, I know you still can drive, that’s not even a question, but you know what happened the other day? I was out on the highway and this car cut me off, and I had to make a split-second decision it was really scary Its likely they will say, You know what? I’m having a little trouble with those decisions too. The issue isn’t the mechanical driving, it has more to do with comprehension, and many times this answer works much better than, You can’t drive anymore, which can be construed as confrontational.

You may find a patient and/or loved one up too early or confused about time. Instead of using messages such as, Youre up too early, you need to go to bed, try leading with statements such as, You know, I’m getting sleepy. Id like a little snack before I go to bed, and then gesture for the patient and/or loved one to sit with you.

Cope With Changes In Communication

As your loved ones Alzheimers or dementia progresses, youll notice changes in how they communicate. They may have trouble finding words, substitute one word for another, repeat the same things over and over, or become easily confused. Increased hand gestures, losing their train of thought, and even inappropriate outbursts are all common as well.

Even if your loved one has trouble maintaining a conversationor less interest in starting oneits important to encourage social interaction. Making them feel safe rather than stressed will make communication easier, so try to manage your own frustration levels.

Be patient. If your loved one has difficulty recalling a word, for example, allow them time. Getting anxious or impatient will only inhibit their recall. Gently supply the word or tell the person that you can come back to it later.

Be aware of your body language. Your loved one responds to your facial expression, tone of voice, and nonverbal cues as much as the words you choose. Make eye contact, stay calm, and keep a relaxed, open posture.

Speak slowly and clearly. Give one direction or ask one question at a time, use short sentences, and give your loved one more time to process whats being said. Find a simpler way to say the same thing if it wasnt understood the first time.

Maintain respect. Dont use patronizing language, baby talk, or sarcasm. It can cause hurt or confusion.

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Tips For Communicating With Your Parent

• Avoid power struggles. Dont push, nag or harangue your parents. Making ultimatums will only get their backs up, and yelling, arguing or slamming doors could seriously damage the relationship. Laura Ellen Christian, 15 Expert Tips for When Your Aging Parents Won’t Listen, The Arbor Company Twitter: @ArborCompany

• Ask about your loved one’s preferences. Does your loved one have a preference about which family member or what type of service provides care? While you might not be able to meet all of your loved one’s wishes, it’s important to take them into consideration. If your loved one has trouble understanding you, simplify your explanations and the decisions you expect him or her to make.

Caregiving In The Middle Stages Of Alzheimers Or Dementia

As your loved ones Alzheimers disease or dementia symptoms progress, theyll require more and more careand youll need more and more support as their caregiver. Your loved one will gradually experience more extensive memory loss, may become lost in familiar settings, no longer be able to drive, and fail to recognize friends and family. Their confusion and rambling speech can make communicating more of a challenge and they may experience disturbing mood and behavior changes along with sleep problems.

Youll need to take on more responsibilities as your loved one loses independence, provide more assistance with the activities of daily living, and find ways of coping with each new challenge. Balancing these tasks with your other responsibilities requires attention, planning, and lots of support.

Ask for help. You cannot do it all alone. Its important to reach out to other family members, friends, or volunteer organizations to help with the daily burden of caregiving. Schedule frequent breaks throughout the day to pursue your hobbies and interests and stay on top of your own health needs. This is not being neglectful or disloyal to your loved one. Caregivers who take regular time away not only provide better care, they also find more satisfaction in their caretaking roles.

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Helping Someone With Everyday Tasks

In the early stages of dementia, many people are able to enjoy life in the same way as before their diagnosis.

But as symptoms get worse, the person may feel anxious, stressed and scared at not being able to remember things, follow conversations or concentrate.

It’s important to support the person to maintain skills, abilities and an active social life. This can also help how they feel about themselves.

Dont Expect Them To Conform To Present

As strange as that may sound, learn how to enter into the patients/loved one’s world and not expect them to conform to our present day. As Diane Waugh, BSN, RN, CDP, says in the video above: When I had to deal with memory loss with my own mother, I found the hardest thing for me to do was to not try to drag her into my reality, but to go live where she was living, in her understanding.

Caregivers and/or family members should remember: give up expectations of the patient and/or loved one . Giving up expectations can make room for what the patient and/or loved one’s strengths are .

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Telling About A Death

Here are some hints for telling a person with dementia about a death:

• Tell the news as soon as possible. They will sense that something is wrong and need information to understand, even if just for that period of time.
• If you are too emotional to talk to them, find someone else maybe a friend or healthcare professional.
• Choose a time to talk when the person with dementia is well rested.
• Use short, simple sentences. Dont give too many details this may overwhelm them.
• Answer questions as honestly as possible.
• Use clear words like died instead of passed away or at peace now.
• Try not to protect the person from the truth by suggesting that the person who has died is away and will return later. This can cause worry and agitation later when the person does not return.
• You can support them with physical touch, such as a hug or holding hands.
• Consider involving the person with dementia in funeral planning, assigning a simple task. This will help the death be more real for them. They may recognize the rituals around death and act appropriately.
• Plan for someone to be with the person during services who can also take them out if they become agitated.

Losing Inhibitions Or Exhibiting Inappropriate Sexual Behavior

These behavioral changes can be shocking, but the person with dementia doesnt usually intend to be offensive or inappropriate. Examples might include making rude comments or touching themselves inappropriately in public.

Remember that each person experiences dementia differently. The type of dementia a senior has can also make a difference in the personality changes you see.

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Things Not To Say To Someone With Dementia

Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.

For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.

1. Youre wrong

For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.

Instead, change the subject.

Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.

2. Do you remember?

Instead, say: I remember

3. They passed away.

Instead

4. I told you

Instead, repeat what you said.

Instead, leave the room.

How To Interact With A Family Member With Alzheimers

Interacting with a family member with Alzheimers can sometimes feel like a moving target. During the day, your family member may go from calm to agitated and back again.

There are good days, bad days, and everything in between. Much has been written about how to interact with a family member with Alzheimers and you may have to experiment with what works best.

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First Its Good To Be Aware Of The Signs Of Anger Such As:

• Shortness of breath
• Tense muscles, a tingly sensation in your body
• Clenching your fists and/or jaw
• Sweating, getting red in the face
• Speaking in a louder voice
• Maybe even wanting to hit the other person

If you notice some or all these arising in you, tell yourself, Im getting angry and I need to be careful about how I respond, take several slow, deep breaths before responding, and even take a time out .

Use Simple Clear Communication

Open-ended questions can be overwhelming for someone with Alzheimers disease. Yes or no questions work better. When communicating, try and speak slowly and clearly with a simple sentence structure.

It can also help eliminate other distractions that can create confusion. If it seems appropriate, use physical gestures like holding a hand to create warmth and comfort.

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Take A Break From Caring

Taking regular breaks can help you to look after yourself and better support you in caring for someone with dementia.

Family and friends may be able to provide short breaks for you to have time “just for you”.

Other options include:

• day centres social services or your local carers’ centre should provide details of these in your area
• respite care this can be provided in your own home or for a short break in a care home

Getting Lost Outside The Home

A person with dementia may leave the house and forget where they were going or why. They may also have problems recognising familiar environments and this can lead to them getting lost or coming to harm.

How you can help

• If the person gets lost when going out alone, consider going out with them, or arranging for someone else to do so.
• If the person is happy to, it can help if other people who live nearby are told about the persons difficulties. People like neighbours and local shopkeepers may be able to help if the person gets lost.
• The person may find having a mobile phone useful. There are easy-to-use mobiles available if the person is not used to having one. You may also consider using assistive technology products, such as a GPS device. For more information see Using technology to help with everyday life.
• Make sure the person has some form of identification when they go out, as well as contact numbers of people they know well. An emergency identification device, such as those provided by MedicAlert, may be helpful.

Alzheimers Society also provide helpcards that people with dementia can carry around with them in case they need assistance when out in the community. See our information on supporting a person who often leaves the house.

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Tips For Managing Your Loved Ones Confusion

Simplification is key here, Hashmi says. To help minimize confusion, he suggests several ways to simplify both the home environment and your interactions:

Provide structure.

• Keep familiar objects around to help reorient your loved one.
• Label drawers and cabinets. This is especially helpful if confusion about where to find things is a common trigger.
• Use tools such as alarms, calendars, and to-do lists to help them remember tasks.

Deliberately use simple, short sentences and ask yes/no questions.

• Normalize their experience. Say, Youre confused. Its okay. Well figure it out together.
• Lead with what you think might be happening. For example: It seems like youre looking for something.
• Its often much easier for your loved one to answer yes or no questions, instead of coming up with the words themselves. Are you looking for your keys? Are you looking for your glasses?

Lastly, Hashmi says, it helps if you can learn to accept the confusion. In the moment, he says, whatever your loved one thinks is real is in fact their reality. For example, they might think theyre at work when theyre really at home. If that belief isnt hurting them or anyone else, its OK for you to play along a little bit. Confronting or trying to change the belief often leads to agitation and aggression.

For us as caregivers, we have to be OK with that confusion, Hashmi says.

Tip : Plan For The Future

While its not easy to think about, getting your finances in order and figuring out how you want your healthcare handled can give you a sense of power over your future. Talk with your loved ones and communicate your wishes. Discuss and document treatment and end-of-life preferences with your doctors and family members. Appoint someone you trust to make decisions for you when you can no longer make them for yourself.

Although these conversations may be difficult, making your wishes known can also be empowering. And by making important decisions early, youll avoid future medical, financial, and legal confusion.

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Tip : Pursue Activities That Bring You Meaning And Joy

Having Alzheimers or another dementia doesnt mean your life has to stop moving forward. By pursuing meaningful activities and relationships, you can continue to nourish your spirit and find pleasure and purpose in life.

Even when symptoms advance and certain activities become difficult, you can still find other ways to nurture and enrich your spirit. If you can no longer paint, for example, you may still be able to visit museums and appreciate the art of others. Or if you can no longer cook, you may still be able to devise the menu and help shop for ingredients.

While we all have different ways of experiencing meaning and joy, you may want to:

Pursue your favorite hobbies and interests. Engaging in activities that are important to you can help maintain your identity as well as enrich your life. Try taking a class or joining a club to keep your interest growing or to explore new activities.

Build your legacy. In the early stages of dementia, many people are mindful of how they want to be remembered. Maybe you want to pass on your skills and knowledge to others, or leave a record of your life for your grandchildren to enjoy. You might want to create photo albums, write your memoirs or a how-to book, share your favorite recipes, make a record of family traditions, or research your family history. Or perhaps you simply want to spend time with your closest loved ones to create new memories.