"Do you have any knitting patterns? I want to knit for my granddaughter, and I need to look at some patterns."
I looked at her helplessly. This lady couldn't knit any more, let alone follow a pattern. What should I say?
She was the mother of our neighbours at the time. Both our townhouses were on either side of the parkette, and we often met there while watching our children. Sarah's mother had Alzheimer's and had been deteriorating. When she could no longer live alone, Ralph and Sarah built an in law suite in the basement and had her live with them. She often accompanied them on the trips to the park. She, like my own mother, was one of those unfortunate people with early onset Alzheimer's. She might have been 60.
This was long before I had much experience with people with dementia, but miraculously, I did the right thing. "Sure, I don't have much, but I'll bring what I have out the next time I come." The next day, I came out with a fistful of pattern books, and she was delighted. She poured over them like holy grail, and eventually asked to borrow one. "No problem. Take as long as you like with it." Sarah returned it a few days later. Her mom had forgotten about it, and about her desire to knit. But for those few moments in the park, she was doing something she loved, and it gave her intense pleasure.
Isn't that what it's all about?
Communication with someone with Alzheimer's is different. Reality therapy used to be popular a few years ago. The best thing for people with dementia was to bring them back to reality. What day it is, what time, and what is really going on. Reality therapy would have said, "You can no longer follow a pattern. You don't knit any more. You have no use for a knitting pattern." The philosophy was that bringing people back to reality somehow grounded them and brought about less confusion and anxiety. The truth was, the opposite occurred.
Here are a few more communication tools:
* Don't press for an answer if it causes confusion or anxiety.
I love to give people choice, because it maintains their independence and allows them to express who they are through choosing what they like. This is no more evident in the dining room. The key is to go slowly, and break it down. "Would you like chocolate, strawberry or vanilla?" If there is no answer, I say, "Do you like chocolate?" and on we go from there. Occasionally, making a choice causes stress. Maybe they like all three, but don't know how to tell me to make a triple scoop. If I see anxiety starting, I drop it. I'll give them vanilla and try again next time.
* If you hear the same story or comment more than once (or twenty times) answer it as if it was the first time. "Am I knitting a square?" "Yes, I put the sample on your leg there." "Do I just keep knitting?" "Yes, you can follow the sample that's on your leg." "Is it supposed to be a square?" "Yes, see the sample on your leg? You can tell how big it is to be from that." "So I'm knitting a square?" "Yes, you are. You can measure it against the sample on your leg." It takes patience, but it gives the gift of respect.
*Don't grill for information. "What did you do today? What did you have for lunch?" All you are doing is putting an underline on their disease. They can't remember. Don't ask. Instead, be more creative. "I see spaghetti was on the menu at lunch. That was always your favourite." This may lead to reminiscing, or at the least, a happy memory of a plate of spaghetti! The goal is to communicate, but on their terms, not yours.
It's like learning a new language, but the list of vocabulary words and what they mean changes frequently.
Next week: more tips for meaningful communication