Wednesday, 6 April 2016

Care Partner Wednesday--The Big Lie(s)

I lie.
Every day.
It's shocking, really.

Here's an example of one of my lies from today:

Dr. M.: Have you seen my wife?
Me: I saw her at lunch. (That was true.)
Dr. M.: Do you know where she is now? I can't find her.
Me: She's running some errands (not true), but she will be back at dinner.(true.)
Dr. M.: Where does she live?
Me: I'm not sure (not true) but I know she will be back to have dinner with you. (true)


J.: I want to pick some things up at the grocery store.
Me: Oh my, it's so cold out there. Could we wait and see if it warms up tomorrow?
 (It's cold, but I've seen much worse, and I have no intention of going to the grocery store today or tomorrow, either.)


L: I need to leave. My parents will be looking for me, and my father will be mad.
Me: Why don't you stay and have dinner with us? It's all made.
L.: I can't. I don't want my father to be mad at me.
Me: I'll call them. (I pick up the phone and pretend to dial.) Hello? Yes, I just wanted to tell you that L. is here at Christie Gardens, and she is going to have dinner. Is that alright? Okay, I'll tell her.
(to L.) They said to enjoy your dinner and they'll see you later. (I hang up the phone.)

So what is happening here?

Communication with someone with dementia.

The most important thing in communication is hearing what isn't said. Peter Drucker

In the first conversation, Dr. M. has just moved in, and is in a transition time. He needs reassurance. If I were to tell him what floor his wife lives on and he set out to find her, not only would he get lost, but it would increase his anxiety (and hers!) Each day he is making more connections on this floor. After our conversation, he happily went down the hall, the stress of looking for his wife gone for the moment.

J.  has a private companion who goes to the store with her once a week, and they buy clothes or the occasional edible treat.  If J. went to the store by herself, she would get lost. I was able to distract her as we talked about something else, and the trip to the grocery store was forgotten.

L.'s parents have been dead for decades, but her reality is that she is a young girl, and she needs to be home for dinner. By entering her reality and "talking" to her parents, I relieved her stress and anxiety. She happily ate her dinner, and forgot all about going "home" after.

The basic principals are:

  1. Think like the person with dementia. What might relieve their anxiety?
  2. Be creative. 
  3. If something doesn't work, try something else.
  4. Enter their reality. Where are they? L. saw herself as a young girl at home with her parents. This is common as short-term memory fades, and the memories of long ago become more real.
  5. Don't correct. ("Your parents have been dead for years.") This will shock and upset, and is never helpful.
  6. Don't reason. You can seldom out reason someone with dementia.
  7. Don't argue. You probably won't win, and you'll both get frustrated. In the end, they will be convinced you are wrong.
  8. Divert, if possible. Make use of that short attention span and try to turn the conversation to other things.
Communication with someone with Alzheimers is challenging and hit and miss. You won't score every time. But when communication happens, it's pure gold!

What has worked for you? Share with us some of your communication strategies.

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