Alzheimer's blog

Strategies for dementia caregiving

By Angela Lunde August 4, 2009

This summer's Greater Iowa Chapter Alzheimer's Association newsletter had a piece titled, "Ten real-life strategies for dementia caregiving." I like the piece and want to share a few of them with you, plus one of my own.

Being reasonable, rational and logical will just get you into trouble.
When someone is acting in ways that don't make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the person with dementia doesn't have a "boss" in his brain any longer, so he doesn't respond to our arguments, no matter how logical. Straightforward, simple sentences about what's going to happen are usually the best.

Therapeutic communication reduces stress.
We tend to be meticulously honest with people. However, when someone has dementia, excessive details may lead to distress, for both them and the caregiver. Does it really matter that your loved one thinks she's the volunteer at the day care center? Is it OK to tell your loved one that the two of you are going out to lunch and then "coincidentally" stop by the doctor's office on the way home to pick something up as a way to get her to the doctor?

It's perfectly normal to question the diagnosis when someone has moments of lucidity.
One of the hardest things to do is remember that we are responding to a disease, not the person. Everyone with dementia has times when they make perfect sense and can respond appropriately. We often feel like that person has been faking it or that we've been exaggerating the problem when these moments occur. We're not imagining things; they're just having one of those moments to be treasured when they occur.

Offering a sense of control goes a long way.
All of us want to feel like we're in control of our own lives and have the capability to make our own choices. This doesn't change when someone has dementia — even the later stages of Alzheimer's disease. Although somebody with advanced Alzheimer's disease is no longer capable of maintaining the independence and choice they once had, we have the opportunity to offer them at least an "illusion of control". For example, instead of saying, "I want you to take a bath now" you could say, "I know how much you love taking a bath on Sunday evenings, thank you for letting me help you out."

The advice I often give caregivers is to communicate with words, tone and body language that can most often generate reassurance and a sense of contentment.  When we communicate in this way, we're letting go of our own need to control a disease which we simply cannot.

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Aug. 04, 2009