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Advice to caregivers: Reassure and don’t argue

Senior Woman Sitting In Motorized Wheelchair Talking With Nurse In Retirement Home

Dr. Beverly Jones always dispenses this advice to the Alzheimer’s caregivers who come through his office: You will never win an argument with an Alzheimer’s patient.

“Family members simply cannot recognize how severe the memory loss is,” he said. “They see the same person on the outside and just can’t comprehend how different they are on the inside.”

Winston-Salem doctors specializing in geriatrics and other seniors advocates shared their tips on living day to day with an Alzheimer’s patient.

Set up a no-argue zone. “If you argue with a person with dementia, both people just end up upset, and nothing is accomplished,” said Dr. Kaycee Sink, director of the Kulynych Memory Assessment Clinic at Wake Forest University Baptist Medical Center. “With dementia, logic and reasoning are failing, and the person with dementia truly believes that the way they think is correct. If it’s a minor issue, just concede. Put on your turtle shell and just let it slide off your back.”

Keep communication short and direct. “If a certain attempt is not working, come back to it later, maybe another way,” Jones said. “You must pick your battles, and you must be flexible as a caregiver.”

Don’t correct everything, especially if it’s inconsequential. “If you try to make a point, it doesn’t matter, because two minutes down the road, she won’t remember it anyway,” said Scott Trotter of Winston-Salem, who takes care of his mother.

But what if the things the Alzheimer’s patient says really are untrue and are harmful? One Alzheimer’s patient, for example, told everyone she met that her daughter was spreading lies about her.

“You may never be able to convince her of the truth,” Sink said. “In this case, for example, the daughter might have to make phone calls privately to the people her mother has spoken to and say, ‘This really didn’t happen.’ But mostly, the people already know that the mother has problems.”

Don’t take away what the Alzheimer’s patient can do. Pick an activity that is appropriate to the person’s level. If she can’t cook an entire meal, perhaps she can slice the tomato for the salad.

“Allow them to do as much as possible, even if it’s not up to standard,” Sink said.

Do things on a schedule as much as possible, Trotter said. This usually means less hassle.

Always sit and listen, no matter what the loved one is talking about. Don’t say you don’t understand what they are saying. “The few times I caught myself saying ‘I don’t understand,’ that would just frustrate her more or make her angry,” Trotter said.

Don’t let the person see you get upset. Hide it and vent later with a friend or loved one, Trotter said.

Don’t treat the person as a child, even if some behaviors are childlike.

Don’t push someone to do things he cannot, such as a crossword puzzle that is too difficult.

If a person with dementia is upset, try to get at the underlying emotion, Sink said.

For example, one man with Alzheimer’s routinely worried that his money was going to run out and that he would be left poor. His daughter kept his bank statements nearby, showing them to him again and again. “Look, Daddy, here’s your money, safe and sound,” she would say, and each time he would relax a bit.

Sometimes it almost takes stumbling upon the right words to calm an Alzheimer’s patient. Sink told the story of one woman with dementia who worried constantly about her parents, who had long since died. She shouted out again and again, “Where’s my mother and father?”

Various people told her, “They are coming for you,” but then the woman became worried that her parents were lost.
Finally, someone told her: “Well, I don’t know where they are, but they know where you are. And they love you very much.” This satisfied and relaxed the woman, at least for a while, Sink said.

Perhaps most important: Caregivers must give themselves a break.

“Build in some support for yourself, in terms of people who can help,” Jones said.
The community offers adult day programs; take advantage of them, he said.

“The biggest problem I see is that caregivers work themselves to death,” Jones said. “Literally. I have seen some caregivers who died before the Alzheimer’s patient did. Lower your expectations and take it day by day.”