Written by Lolita Tramel, FNP-BC, PMHNP-BC, CDP, CADDCT NURSE PRACTITIONER & DEMENTIA EDUCATOR, Founder & CEO of Hearts for Dementia Home Care
If you have experienced a loved one being taunted by this horrible disease, then you may understand the struggles and the difficulty it takes to care for someone with this neurodegenerative disorder. I found myself facing this turmoil when my best friend, my mother, lost her memory to Alzheimer’s Disease. Coping with her memory loss was devastating. Frequently, I found myself compelled to repeatedly orient her to my reality. I would say, “You just asked that question don’t you remember…” Challenged by own convictions, I realized the distress ineffective communication and reality orientation can cause for persons living with dementia.
When caring for someone with Alzheimer’s disease, effective communication is key. Do not remind persons with dementia that they are asking the same questions repeatedly. Although this may seem annoying and quite frankly frustrating, the frequent reminders are counterproductive. Be mindful that this individual has brain disease. It is imperative to be patient. Remain calm and answer the question or redirect them after validating their feelings. Speak slowly in small simple phrases. When asking persons with dementia a question, ask one question at a time and wait for a response.
The biggest takeaway is to always validate feelings and live in their reality. Respond to the person living with Alzheimer’s disease as if their perceptions are reality. A man named Paul once shared a compelling story about his wife, Jan, who suffered from Alzheimer’s disease. His wife wouldn’t take a shower because “little men” were in the bathtub. In order to persuade her to take a shower, he validated her feelings and acknowledged that the “little men” existed in the bathtub. He then attempted to remove the little men from the bathtub so she can feel comfortable taking a shower. If Jan’s husband informed her that the “little men” did not exist, this may have led to distress since this was perceived as her reality. As the disease progresses, reality orientation becomes more distressing. Redirecting persons with dementia into reality may cause conflict escalation between the person with dementia and the caregiver. This will frequently cause persons with dementia to experience distress, emotional turmoil and possibly lead to aggressive behaviors.
According to the Alzheimer’s Association, there are approximately 150,000 Arizonians age 65 and older living with Alzheimer’s dementia. By 2025, it is projected that approximately 200,000 Arizonians age 65 and older will be living with Alzheimer’s dementia. Many of you are standing in my shoes or will eventually face this exact same dilemma, of a disease robbing your loved one of their past, present and current reality. As the saying goes, “Be the Change You Want to See in The World.” My hope is for everyone with Alzheimer’s disease to receive a better quality of life. It is imperative to engage in effective communication and avoid conflict provoked by reality orientation.