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Apr 9, 2020

How you approach dementia care matters

by Gary Skole

Tips about how your approach as a caregiver or family member can increase the quality of life for the individual with dementia, caregivers, and family members.

Alzheimer’s disease, along with other forms of dementia, requires unique care.  Your manner, attitude, and the way you approach someone with dementia makes a difference in the rate of success.

Methods of communication matter too.  The many forms of communication become especially important when conversing with someone with Alzheimer’s disease. The spoken word matters, but it's not just what we say but how we say it, as well as facial expressions, tones, body language, pacing of words, even how we ambulate. Basically, our every movement conveys a message to those around us.

The following are a few tips about how your approach can increase the quality of life for the individual with dementia, as well as that of care partners and family:

  • Try to physically approach from the front so you don't startle the individual. With a possible decline in hearing and vision changes, it is helpful to ensure you are making eye contact. This could include wiggling your hand in their line of eyesight, and then bringing their gaze up to your smiling face.

  • Don’t assume they recognize who you are or what your relationship is to them. Sad and challenging for family members, it can be hurtful when a spouse or parent isn’t certain who you are.  Remember, it’s not their fault, it is the disease.

  • Move slowly and be aware of other’s personal space. Are you on their level, are you making a connection?  Ask yourself, “Could standing over them or directly in front of this person make them feel like I am controlling or dominating them, especially if I am telling them what to do?”  How might the individual who doesn’t understand what you are saying or meaning respond to your actions?

  • Focus on what remains. This is such a disease of loss. Don’t think about what they used to be able to do and take it away. Rather adapt their likes and hobbies to their current abilities. Ask yourself, “What can my loved one still do and enjoy? How can I adapt the situation to foster continued enjoyment?”

  • Remove the words, “No, Don’t, Stop!” from your vocabulary. Refrain from saying, “Don’t you remember?”  No, they don’t.  They have a disease of memory loss and no one wants to be reminded of that. Are you acting like the helper of the helpless?

  • Do not argue. You will not win! Everyone involved will just become more upset and possibly more challenging. Go along with it. Ask yourself, “What harm will it cause if I allow this person to believe what they are saying?  Do I want to be right, or do I want to experience peace?”

  • When situations and behaviors do arise, don’t accept that it is the disease and that it has to be that way. Learn what the meaning behind the behavior is.  What is it an emotional response to?  Ask yourself, “What is my loved on trying to tell me through their actions?”

  • The ability to express oneself decreases and even diminishes. Don’t talk about the person as if they are not there if they are present. Even when someone can’t communicate their needs and feelings, it doesn’t mean they stopped having them.  Ensure you are involving them in the conversation.

There should be a give and take.  You are a care partner.  This individual still has something to offer.  The feeling to be needed and to contribute to their environment still exists.  You are a caring nurturer.  But rather than always offering your help, ask them for their help.  This allows the person to regain a sense of belonging and usefulness.  It’s up to you to choose your approach and style of communication, remember to show value and appreciation.  Saying “Thank you” can go a long way.

About the Author

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Gary Skole

Gary is a founder of AlzBetter with decades of experience improving care for patients with challenging healthcare needs at home. He is a published author and frequent speaker on Dementia, Transitional Care Management, and Patient Engagement.