By: Beth Hutchason, MN, ARNP
As dementia progresses, I have heard that the person “no longer knows their family.” That’s not always the truth. They may not recognize their family as they are now but that doesn’t mean the loved one has been forgotten. Many things can be done to maintain the connection to a person with dementia. The key is meeting them where they are. Expecting them to come to us is not realistic and creates much frustration for the individuals living with dementia as well as their caregivers.
Consider these options when trying to connect with a loved one living with Alzheimer’s or another dementia:
- Framing a picture of yourself at a much younger age. You can tell what age is best by talking to the person. What are they talking about? Are they referring to you as if you are living in their home? Are they referring to you as getting on the school bus?
- Speaking to the person out of their vision range (with a hand on their shoulder standing behind their chair or sitting next to their bed at night with the lights off). They may respond better to just hearing you, without seeing you.
- Crouching down in front of a seated person to appear smaller (and therefore younger).
- Not telling them that you are their son, daughter, etc. Use just your first name.
- A person with dementia who sees their spouse, who is recognized, with another person may deduce the spouse is cheating on them. In this case, simply enter separately or visit alone.
Pictures are a particularly helpful tool. They work best not as a “do-you-remember-this” quiz but as a focal point for storytelling. Instead of saying something like “Hey, Mom. Do you remember me at this county fair?”, try saying “Maria, hello! Isn’t this a great picture of Elsa that I found? She sure loved that fair and wearing those Mickey Mouse sunglasses that you got her!” This way, you are providing a memory for them and opening the door to stories and expressions of feelings about that person in the picture. Moments of connection and joy are the goal.
Using Tools To Help Them Along The Way
It is not just the pictures, of course. Objects and their meaning are retained much longer than words. Do they not respond to someone asking them about playing cards or a board game? Pull out the deck or game box, show it to them, and ask them if they’d like to play. Ensure their favorite fishing net, baseball glove, or beekeeping item is nearby. “Boy, Bob. You really caught some fine fish with that net. What was your biggest one?” (Tall fishing tales are the best, according to my husband, the fisherman.)
Meet Them Where They Are
Communication is the key here. Try to understand what the individual with dementia is experiencing and meet them there. There are many resources for communication tips; the Alzheimer’s Association has some fantastic ones here that are tailored to different stages of the disease. I have found that patience is very, very important when trying to communicate. Give the person time to respond to the question. They may well need extra time to take in what was said, process it, formulate a response, and articulate their response.
As I have said before, my dad had Lewy Body dementia. One evening, as the confusion worsened, he could not remember me. My stepmother called me into their room, hoping that seeing my face would remind him. He looked up at me, trying to figure it out. He then took my hand and said, “I can’t remember who you are right now, but I do know that I will love you forever.” He had lost the memory of my name and relationship to him, but he was certain of his love for me. That was more than enough.
I had a plaque made that I placed in my living room as a reminder of that moment:
“I can’t promise that I’ll be here for the rest of your life…but I can promise that I’ll love you for the rest of mine.”
Beth Hutchason has been a registered nurse for 34 years and a nurse practitioner for 26 of those years. She has spent the past 14 years doing palliative care, a branch of medicine focused on improvement in quality of life and relief of suffering. During these years, she has had the opportunity to interact with many hundreds of patients with dementia and their families. They have taught her a great deal, which she hopes to share. She lives with her husband David, beloved dogs Katya and Benson, and about 60,000 largely unnamed bees in Poulsbo, WA.
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