While on a recent road trip, we ended up in Missoula, Montana. During dinner I overheard a conversation between a father and son, sitting in the next booth. The son was talking very loudly so everyone in the area could hear.
Dad said “let’s get in the bathtub and go home.” It was very apparent that Dad had some memory issues. The son’s reaction saddened and overwhelmed me.
The son said, “It is socially unacceptable to say this. Remember you know better.” He then went on for the next thirty minutes trying to explain to Dad what was wrong with what he had said and why. Dad finally got very angry and yelled “leave me the hell alone.”
I called the wait staff over to explain there appeared to be a major problem at the next table. The waitress said, “Oh that is just a father and son. Dad has lost his mind. They will be leaving soon. Would you like to move to another table?”
I was completely appalled at her response as well as lack of concern. I said “I am a Registered Nurse who specializes in Alzheimer’s/dementia care. In my world this exchange is abusive and I would have called it into the state as abuse.” She was shocked and could not understand what the problem was.
It is important to acknowledge that someone you love has a memory problem. You can’t help them if you are ignoring that there, indeed, is a problem. Get your loved one to a doctor for a formal workup. See if there is something wrong that can be corrected. If not correctable, have the doctor work them up or send your loved one to a neurologist to find the cause
Communicating with someone that has memory loss can be difficult. What is important to remember is they can’t help that they can’t remember or often find the right words. If your loved one had cancer you might understand the disease but with a dementing illness, often people don’t.
People with memory loss fall into two categories:
Those who don’t know and don’t know that they don’t know. These people are usually happier and don’t fret about memory loss.
Those who don’t know and know that they don’t know. These people are often more irritable and anxious about the memory loss.
• Be comforting and reassuring. Let the person know it’s OK if he/she is having difficulty expressing him/herself
• Be patient. Give the person enough time to speak. It’s important that the person knows you are willing to listen
• Show that you are interested. Keep listening and maintaining eye contact
• Try not to criticize or correct. Listen as closely as you can in order to find meaning in what is being said. Repeat what was said if necessary
• Offer a guess. If you can’t understand what he/she is trying to communicate, try helping with words
• Look for feelings behind the words. Many times, it’s how something is said rather than what is being said. His/her tone of voice and other actions may help you understand what he/she is really trying to say
• Ask for nonverbal communication. Encourage pointing or gesturing if speaking becomes difficult
• Use short, simple sentences. Long sentences can be confusing. Speak concisely and try to keep it to the point
• Give 1-step instructions. Express tasks or instructions in clear simple steps
• Use the person’s name. Using the person’s name helps to get his/her attention
• Speak slowly and clearly. This will help the person better hear and understand you
• Repeat information or questions. It takes longer for a person with a dementing disease to think about what you say or ask. Wait a moment then repeat the sentence if needed
• Identify objects by name. For example, instead of saying “Here it is,” you might say “Here’s the book”
• Turn a negative into a positive. Rather than saying “Don’t do that now,” you might say “it’s a good time to go for a walk”
• Give him/her a choice. Try to avoid open-ended questions. If you structure questions for a yes or no answer, or if you provide a clear choice, such as “Do you want the TV on or off?” you have a much better chance of getting a response
• Try again later. If you’re not getting a response to a question or request, try asking the same question a little later; you may get a response
• Use a positive, nurturing tone of voice. Speak slowly and clearly, in a gentle and relaxed manner. Be aware of your feeling, which are often communicated through your tone of voice
• Your body language and gestures are important. Try to maintain eye contact and use friendly facial expressions when you speak. You can also make use of pointing, gesturing, and touching to get your point across

*Information regarding communication is from The Alzheimer’s Activity Guide

“I’m so sorry I have this. I can’t stand the thought of how much worse this is going to get. I can’t stand the thought of looking at you someday, this face I love, and not knowing who you are. I don’t know if I can.”
― Lisa Genova, Still Alice