Tips for Talking With Alzheimer's Patients

This morning my mother and I had a delightful conversation.  It started with her telling me about a surprise call she had from her neighbor across the street.  It seems that the neighbor was shopping downtown where she was looking at nice scarves and gloves.  The neighbor said she missed seeing Mama and that Mama didn't need to pay her a special visit . . . that phone calls were a welcome way to stay in touch.  I contributed that I felt the neighbor might be lonely in the big house where she lived alone.  Mama agreed, shared how much she liked the woman, and we went on to another topic.

Our conversation was comfortable and normal in every respect, except that I knew the neighbor had died about five years ago and that Mama lives with me now - not in her old hometown.   It takes some practice and determination to enter the reality experienced by an Alzheimer's patient.  A much more natural impulse is to correct their statements and disregard stories that don't make sense.  Part of the learning process for loving caregivers is to find ways to enter the Alzheimer's world in ways that support calm and stability, rather than generate disruption and anxiety.

Some of my very good friends tried visiting my mother soon after she was diagnosed with Alzheimer's.  After a few attempts, their efforts languished, because they discovered Mama couldn't keep up her part of a normal exchange.  I've learned, since that experience, to prep visitors for a successful conversation with Mama.  Here are some of my tips:

• Act naturally in the greeting and goodbye phases of a visit.  Mama responds normally to the polite "Hello, How are you?  Good to see you.  Hope to see you again" parts of the conversation.
• Avoid questions that require the ability to reflect and remember.  Questions like - "Did you enjoy the weather yesterday?"  "How did you like your birthday gifts?"  "Did you have a cake?" -  seem to create anxiety, because the person is aware that she isn't responding correctly.
• Keep even simple choices to a minimum. Recently, I asked Mama if she'd rather have soup or a sandwich for lunch.  She repeated the question several times, finally became frustrated and discouraged, and offered this reply, "What do you think would be good?"
• Go with their story, if possible.  Try to engage in the story, even if it is patently implausible, untrue, in the wrong time period, etc.  Correcting the story that seems real to them dampens enthusiasm and lowers self esteem.
• Try talking mostly about yourself when you visit.  I tell my friends to describe their holidays, their grandchildren, what they're cooking for supper , where they've been today.  In these conversations, Mama seems at ease and confident that she's contributing - even when the visitor does most of the talking.