Eyes that see the good in things: June 24, 2019

Family members of dementia patients face many challenges, perhaps the greatest is how to communicate effectively. If anyone knows this to be true, it is Bob DeMarco who left his life as a Wall Street Executive to care for his mother, who had Alzheimer’s disease. He has since written much on the topic, and become an expert in the Alzheimer’s community.

For DeMarco, things were most difficult at the beginning when he acclimated to his mother’s new reality. He says his mother “turned meaner than a junkyard dog,” saying mean and nasty things every day, very out of character for her.

He understood that it was the disease at work, that her brain had changed and was sick. Still DeMarco had to remind himself that her new difficult behaviors were simply not her fault. Still this understanding didn’t stop hurt when she said those things. Her words still made him feel angry and sad. “Every day. Day in and day out.”

Over time, he developed a mantra of“Something has to change and that something is me.” He became determined to do what he could to change his mother’s behaviors, but quickly learned how difficult it is to reason with someone living with dementia. Then he found one ritual that worked.

Early each morning, DeMarco would bend down and put his forehead to his mother’s forehead and say something nice and positive. It was his hope to make her feel more secure which ultimately, would help her stop feeling like she had to be a “junkyard dog.” When she would snarl, “get out, I can take care of myself,” he would smile at her, put his head against her forehead and say something positive like, “I am here, and I am not going anywhere.”

Today, she is more like the sweet person he always knew and together they work as a team. DeMarco offers ten tips that he says worked well in best for communicating with his mother. He calls them, “Mom’s ten tips for communicating with people living with dementia.” Below is an adapted version.

• A smile can make me feel safe, secure and happy.

• I get tense and uptight when you get tense and uptight.

• When I do something that seems perfectly normal to me, and perfectly nutty to you, just smile at me. It will take the edge off the situation.

• It is my short-term memory, my right now memory, that is gone. Don’t talk so fast, or use so many words.

• You know what I am going to say if you go off into long explanations about why I should do something? I am going to say no. This is because I can’t be certain if you are asking me to do something I like, or if you want me to drink a bottle of castor oil. So I’ll just say no to be safe.

• Slow down. And don’t sneak up on me and start talking. Did I tell you I like smiles?

• Make sure you have my attention before you start blabbering. What is going to happen if you start blabbering, don’t have my attention, or confuse me? I am going to say no. Count on it.

• My attention span is not as good as it once was. Make eye contact with me before you start talking. A nice smile always gets my attention. Did I mention that before?

• Sometimes you talk to me like I am a child or an idiot. How would you like it if I did that to you? Go to your room and think about this. Don’t come back and tell me you are sorry, I won’t know what you are talking about. Just stop doing it and we will get along very well.

• You talk too much. Try taking my hand and leading the way. I need a guide, not a person to nag me all the time.

Over time, DeMarco says he learned how to communicate in a new, effective way. He also relearned something he learned a long time ago—you get more with sugar than you do with vinegar. And he believes he became a better person along the way. He thanks his mother for that.

Alzheimer’s disease is the most well-known form of dementia, but there are over 100 forms of dementia— all of which affect memory, thinking, behavior and emotion. Common symptoms include memory loss; difficulty with communication and routine tasks, changes in mood and personality and lapses in judgment. As a result, dementia is the leading cause of disability and dependency among the elderly.

Dementia affects almost 50 million people, with a new case of dementia occurring somewhere in the world every 3 seconds. Next to Alzheimer’s disease, stroke is the second most common cause of dementia.

With a large aging population, it is likely many of us have family members living with dementia to some degree. Some might be caregivers, while others are watching from a front-row seat. Whichever seat you’re in, know that a primary caregiver needs respite— literally a rest, a break away from the demands of caregiving. This means other family members and friends will also need to learn to communicate with a loved one living with dementia., The following tips might help.

1. Set a positive mood for interaction: Attitude and body language communicate feelings and thoughts stronger than our words. Set a positive mood by speaking in a pleasant and respectful manner and using facial expressions. The tone of voice and physical touch help convey a message and show affection.

2. Get the person’s attention: Before speaking, make sure you have their attention and use nonverbal cues and touch to help keep them focused. Get down to their level and maintain eye contact.

3. State your message clearly: Use simple words and sentences and speak slowly and in a reassuring tone with a lower than normal pitch. When not understood, use the same wording again.

4. Ask simple, answerable questions: Ask one question at a time; those with yes or no answers work best. Or phrase a question that lets them choose between two choices.

5. Listen with your ears, eyes and heart: Be patient in waiting for a reply. It’s OK to suggest words if they’re struggling to find them. Always listen for the meaning and feelings that underlie the words.

6. Break down activities into a series of steps: You can encourage your loved one to do a task, then gently offer reminders of forgotten steps and assist with difficult steps.

7. When the going gets tough, distract and redirect: When your loved one becomes upset, try changing the subject. It is important to connect with the person on a feeling level. You might say, “I see you’re feeling sad— I’m sorry you’re upset.” Then suggest something they enjoy.

8. Respond with affection and reassurance: People with dementia often feel confused, anxious and unsure of themselves. They often get reality confused and may recall things that never really occurred. Avoid trying to convince them they are wrong.

9. Remember the good old days: Remembering the past can be soothing and affirming as many people with dementia can still clearly recall details 45 years earlier. Music can be a powerful tool in helping them do so.

10. Maintain your sense of humor: Use humor whenever possible, though not at the person’s expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you. 

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