How to Reach Alzheheimer’s Patients
11 essential ways to ease anxiety, affirm their reality—and keep your sanity.
Everything Alzheimer's patients take in through their senses is distorted. Yet one capacity remains. A nurse shares how to minister most effectively to these souls who, still need human companionship and a listening ear, even if they speak in a confused jumble of words or cannot communicate verbally.
Joanne, a League of Mercy member, walks into Mr. Wallace's room with a smile and a War Cry. The 84-year-old man begins to cry, "Have you seen my mother? I have to find my mother."
In a room down the hall, Paul tries desperately to make sense of Mrs. Thomas' gibberish, while another patient screams at her visitor to "Get out!"
Among the *5.5 million people in this country suffering with Alzheimer's disease, confusing situations like these are not unusual. Ministering to someone whose life is governed by confusion can be uncomfortable and difficult, and yet Jesus calls us to serve the "least of these" (Matt. 25:40). Can we truly bring the love of Christ to people who are losing their ability to understand what we say or do?
When we understand what is happening to the person with Alzheimer's disease, and learn a few communication tips, we can effectively bring God's love into their lives.
Alzheimer's disease causes confusion, hallucinations, forgetfulness, paranoia and loss of the ability to communicate. As brain cells die, so does the ability to remember new information. Eventually, Alzheimer's patients lose their memory, and begin to repeat things over and over. Everything they take in through their senses becomes distorted.
Yet the one positive capacity that remains, perhaps until death, is their ability to perceive and respond to emotion. Here are some communication tips for creating positive emotion.
1. Begin each visit with something positive.
A cheerful, calm approach is best. Are there pictures of grandchildren you can ask about? An afghan on the bed to stimulate a question? If there is nothing in the room to help you, talk about the scenery outside the window. Try presenting the War Cry to them by showing a beautiful picture in the issue first. This will give you something positive to talk about.
2. Always introduce yourself and use the person's name.
"Hi, Mr. Wallace. It's Joanne again." No matter how many times you have met him, he probably will not remember you. Approach him from the front and keep your hands visible. This avoids any confusion about what you may be hiding. With a disease characterized by fear, we must do all that we can to lessen anxiety.
3. Nonverbal communication works well with someone who is losing the ability to communicate with words.
Raise your hand to your mouth when asking the patient if she is thirsty, or pretend to shiver when asking her if she is warm enough. A touch on the arm works wonders to create an atmosphere of acceptance and companionship. People with Alzheimer's disease become very sensitive to body language, especially negative body language. Make sure your face doesn't register a frown. Sit down and visit eye to eye. Standing over a person indicates that you are in authority and creates a negative atmosphere.
4. Respond to gibberish by picking up on something from the conversation and talking about it.
If she mentions flowers, try saying, "I love flowers. Did you have a garden?" When you cannot understand, try picking up on the emotion that is expressed and validate it. "That seems to make you sad." Or, "It makes you happy to remember that, doesn't it?"
5. Remember that he can never come back to your reality; you have to go to his.
His reality is only what he sees, and what he sees is often distorted. It does no good to correct him. If he is talking to his father in the mirror, and wants you to see him, go to the mirror and say something like, "You really enjoyed your father, didn't you?" You can meet his needs by acknowleding his reality, in the same way you meet the needs of preschoolers when you play pretend games and enter their reality.
If he thinks that it is 1927 and he must go to work, try distracting him rather than correcting him. "What kind of work did you do?" His memory loss can work to your advantage here. When he is busy doing something else or talking about something else, he will often forget what he was doing earlier.
If reference is made to his long-dead mother as though she were still alive, it is not helpful to say that she is dead. The patient will grieve as if hearing about the death for the first time. Try asking him about the mother. This validates his feelings without confronting him with a painful reality that has been forgotten for the moment.
6. Never use the word "no."
You can change behavior by changing the environment or by modeling something that you want the patient to do, but not by reasoning with him. If he doesn't want to put a coat on, tell him you are cold and put your coat on. If he is crying to go home, say: "That's a nice idea. We'll do that, but let's have lunch first. What's your favorite sandwich?" As you talk, lead him gently to the kitchen or into another room. Distraction and redirecting thoughts are key to handling difficult situations.
7. Use humor whenever possible.
The sense of humor develops during Alzheimer's. Laughter serves to relax both you and the person you are visiting. Poke gentle fun at yourself. "You know me, I can never get it right the first time." Tell a cute story about your children, or something that happened at home. Even if the patient cannot understand what you are saying, she can enjoy laughing with you.
8. Don't take it personally.
If a person should become agitated, it is part of the fear and anxiety that goes along with Alzheimer's disease. Do your best to soothe and comfort, understanding that we cannot avoid every possible upsetting situation.
Music works wonders to calm a person. Often patients who cannot remember anything else will remember a chorus from childhood. If you aren't musically inclined, or if you would rather die than sing in public, try playing a tape of "oldies" or Sunday school choruses. Help them tap their hands to the rhythm.
People with Alzheimer's are used to failing. They need to be affirmed when they succeed, even if the success is choosing a sweater that morning. Use every opportunity to praise.
If you are not sure what to do in a situation, say a brief, silent prayer. God knows what to do. If you are comfortable, pray with the person. There is nothing quite as comforting as being brought before the Lord by someone else. Write down the names of those you visit and bring them before the Lord. Prayer is one of the greatest gifts that we can give those to whom we minister.
So, how should Joanne and Paul have handled their situations? Joanne might try saying, "I bet you've had fun with your mother. Tell me about her." Paul might try sitting with Mrs. Thomas and picking up on something that she says to begin talking about.
With an understanding of what happens in Alzheimer 's disease and a few communication tips, those who care for them can show them the love and mercy Jesus has for His ailing children.
Lori S. Johnson is a soldier at the Old Orchard Beach Corps, Maine.
*Alzheimer’s Association. 2017 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2017;13:325-373.