The mental changes that accompany Alzheimer's and other forms of dementia not only impact a person's ability to recall past events, they can dramatically alter that individual's capacity for communication.
Here are ten tips to keep conversations with a cognitively-impaired loved one positive and valuable for everyone involved:
1. Face-off: Establishing friendly eye contact and using a person's name are good rules of thumb to follow during any kind of dialogue. When speaking to a loved one who has Alzheimer's or some other form of dementia, the Alzheimer's Foundation of America suggests making sure you get their attention by saying their name. Assure them that they have your full attention by facing them and looking them in the eye.
2. Diminish distractions: Background noise from a television, radio—or even a fan—can distract your loved one during a conversation, making them more likely to lose track of what the discussion is about. Find a quiet place where the two of you can converse in peace.
3. Converse one-on-one: The more people who are involved in a discussion, the more complicated it becomes. Try to keep talks with a person who has Alzheimer's one-on-one whenever possible. Even small groups of three or four people could make your loved one confused and anxious.
4. Keep things simple: According to the Mayo Clinic, comments and conversations should be kept short, simple and to the point. You should always refer to nouns by their actual name (i.e. when pointing out a pretty bird on a walk, say "bird" instead of "it"). Also, being faced with too many choices can be frustrating for someone with Alzheimer's, so steer clear of open-ended questions. For example, if you're having a discussion about what outdoor activity your loved one wants to do, don't say, "Where would you like to go today?" Instead, it's better to ask, "Would you like to go to the park?"
5. Avoid conflict: Don't argue with a person who has Alzheimer's—you won't win and it'll only make both of your more agitated. Avoid inflammatory comments, such as: "I just told you that," and "You're wrong." It's important that you learn to recognize when giving in and walking away from a brewing feud is the best course of action.
6. Extra points for patience: Be patient when talking to a loved one with Alzheimer's. Resist the temptation to complete their sentences—it won't help them remember and it's likely to be more frustrating than anything else. Instead, try asking a question that might jog their memory. For example, if they are wandering around the kitchen and saying, "I want…I want…," you can ask, "Are you hungry? Would you like something to eat?"
7. Enter their world: Conversing with a person struggling with Alzheimer's means making a pledge to temporarily live in their reality—which can be much different from yours. The Fisher Center for Alzheimer's Research refers to this approach as, "reality therapy." Depending on what stage of the disease they are in, your loved one may believe that their deceased spouse is still alive, or that they are an accomplished singer. As long as living in their reality isn't hurting anybody, it's best to just play along. If this makes you feel guilty, remember that their mind has been hijacked by disease and no amount of persuasion on your part is going to convince them that they are wrong. Providing support and validation will go a long way towards easing their anxiety and brightening their mood.
8. Clue into visual cues: Body language is a powerful conversation tool, no matter who you're talking to. Physical indicators can be especially important when you're trying to communicate with someone whose cognitive ability is diminished, says the Mayo Clinic. Your loved one may not be able to verbally articulate their happiness or frustration, but paying attention to facial expressions and body positioning can help you determine their disposition.
9. Get creative with your communication: If words are not sufficient enough to get your point across, don't be afraid to experiment with different types of communication. The Fisher Center suggests utilizing verbal, visual and auditory cues to help your love one understand. For example, if you want to know whether they would like turkey or ham on their sandwich, it might help to pull out and point to each option as you ask the question.
10. Just keep talking: Even if you're caring for a loved one who has limited powers of speech, or who can no longer talk at all, don't underestimate the power of conversation. The Alzheimer's Foundation of America says that talking to a non-verbal sufferer is a good way to indicate to your loved one that you still support them, not only as their caregiver, but as a family member who loves them.
No matter what stage of Alzheimer's your loved one is in, communication and human connection is vital for their well-being.
Harry Urban, who has lived with an Alzheimer's diagnosis for more than seven years, puts it this way, "It may seem pointless, but you should always talk to us—we're still in there. You have to know that you've reached us, even if we don't look at you or respond."