Visiting Someone with Memory Loss

By Dan Kuhn, LCSW, Vice President of Education, All Trust Home Care

This month we are pleased to share an article written by our good friend, Dan Kuhn, who is the Vice President of Education for All Trust Home Care, located in Hinsdale and Deerfield, IL.  For more than 40 years Dan has been a licensed clinical social worker and educator in the fields of healthcare and aging.  Since 1987 he has focused on dementia care, end-of-life care, and family caregiving issues and he has worked for several local organizations including the Rush Alzheimer’s Disease Center, the Alzheimer’s Association, and Rainbow Hospice and Palliative Care.  For more additional information on All Trust Home Care, visit their website at: http://alltrusthomecare.com/

A person with memory loss due to Alzheimer’s disease or a related dementia will experience changes in communication skills – both expressing oneself and understanding others.  These are some of the changes you may notice that gradually appear over time:

In order to keep connected, your approach is key: 

• Identify yourself. Approach the person from the front, make eye contact, and explain who you are if there is any doubt.  Do not quiz someone about your name or the nature of your relationship.
• Position yourself. Sit close by, at eye level.  Gently touch the person with a handshake or hug.
• Limit distractions. Turn off a TV or radio.  Find a place that is quiet, so that he or she and you can focus on thoughts and words.  Having more than one person at a time can be overwhelming.  One-to-one conversation works better,  especially if the person has hearing loss.
• Avoid criticizing or correcting. Don’t tell the person that what is being said may be incorrect or untrue.  Rather, listen and try to find meaning in what is being said.  Repeat if clarifications is needed.
• Don’t Argue. If something is said that you don’t agree with, let it be.  Arguing makes things worse.
• Be patient and supportive. Respond to repeated questions, but redirect to another topic if the person gets stuck in a loop.  Let the person know that you’re listening and trying to understand what is being said.  Let the person describe what he or she wants, without interruptions.  Ask questions to clarify.
• Avoid advance notices. Talking about upcoming plans may be confusing.  Be in the moment instead of preparing the person for a future activity such as, “You have a doctor’s appointment next Tuesday.”
• Offer a guess. If the person appears frustrated, try helping out.  As long as you understand, the right words may not be necessary.
• Offer comfort and reassurance. If the person is having difficulty expressing oneself, say it’s okay.  Encourage words and thoughts, no matter how jumbled.
• Focus on feelings, not facts. Look for the feelings behind the words.  At times, tone of voice and other actions may help you understand how the person is really feeling.

In order to keep connected, choose your words carefully: 

• Provide simple explanations. Avoid using logic and reason.  Respond clearly and concisely.
• Use short, familiar words and sentences. Don’t overwhelm the person with lengthy requests or stories.  Speak concisely and get to the point.
• Talk slowly and clearly. Be aware of speed and clarity when speaking.  Don’t rush.
• Give simple directions. Break tasks and instructions into simple steps, one step at a time.
• Ask one question at a time. Don’t overwhelm him or her with more than one question at a time.  Use questions with two responses rather than open-ended questions: “Would you like to take a walk or listen to music?”  “Would you like to eat chicken or fish?”
• Turn questions into answers. Try providing a solution, rather than the question.  For example, say “The bathroom is right here” instead of asking, “Do you need to use the bathroom?”
• Avoid pronouns. Instead of saying, “Here it is,” try saying “Here is your sweater.”
• Repeat information or questions. If you get no response, wait a moment and ask again.  Use the same phrasing or simplify what you’ve just said.
• Give visual clues. Demonstrate your request by pointing, touching or beginning a task for someone.
• Avoid quizzing. Reminiscence can be useful, but avoid asking questions that rely upon one’s short-term memory.
• Be creative! Try singing or play familiar music to tap into long-term memories.  Use a CD player, an iPod, or a similar device with headphones – kids and other young people can download favorite tunes.

Here are more examples of things to avoid saying and alternatives:

For additional information about estate planning or long-term care planning for your loved one with Dementia, contact a certified Elder Law Attorney such as Linda Strohschein and her team at Strohschein Law Group.  To set up an appointment, contact Strohschein Law Group at 630-377-3241.