Good Afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “Memory and Language in the Moderate Stage of Alzheimer’s.”
Moderate Alzheimer’s is typically the longest stage of the disease and can last for years. Conversations during this stage can be difficult because the person with AD can no longer remember thoughts long enough to express them. They also can’t recall questions long enough to answer them. Although your loved one’s short-term memory may have disappeared, their long-term memory still may be intact.
Here are some tips for stimulating their memories.
· Accept wholeheartedly that the person you’re caring for may not remember from one hour to the next or one day to the next what the plans for the day are or where familiar items, such as dishes, groceries or clothing, are located.
· Create opportunities to reflect on life. Go through old photo albums and talk about happy, memorable times and events.
· Play the bean bag game. Place two chairs facing each other about 5 or 6 feet apart. You sit in one and the person with Alzheimer’s in the other. You toss the bean bag and, at the same time, ask the person with AD a simple question that can be answered with one or two words. The bean bag is then tossed back to you and the action is repeated. Mix things up by asking your loved one to ask you a question.
· Sing familiar songs that evoke memories and feelings.
· Label things, like plants, objects and drawers, to give your loved one cues to help remember information that came so readily to them in the past. Use large, bold labels that are easy to read. Being able to name things will give them more independence.
It’s also important to embrace the memories that remain.
· A caregiver can be rattled and scared when their loved one can no longer follow simple directions. This isn’t necessarily a gradual change. You may suddenly be aware that when you say something as simple as, “Put this in the closet,” the person doesn’t understand what you mean and can’t carry out the instruction. In the face of this loss, it’s normal to become frustrated. It’s not until you realize the ramifications of the loss will you find more creative ways of dealing with it.
· Don’t stop giving directions. Keep the tasks simple. Just remember that with short-term memory loss, you might have to help them carry out the task.
· While your first instinct may be to tell your loved one that they have a memory problem, confronting them with their loss of ability will only diminish their sense of dignity and self-esteem. Instead, remind them how much they can still do and tell them they’re loved and valued.
Communication between caregiver and the person with AD is an extremely important—and often difficult—part of the caregiving process. Many times, those in the moderate stage of the disease get angry or agitated because they don’t know what other people expect of them. They often are frustrated by their inability to be understood and understand.
It’s important to remember that, at this stage, some individuals may repeat the same sounds or statements or revert to their original language to communicate. In my case, I remember times when my mother would open her mouth to speak and jibberish came out.
Attempt to understand. Some Alzheimer’s sufferers may insert the wrong word in a sentence. For example, they might say, “I want to eat my hair,” instead of “I want to brush my hair.” Show them that you understand and don’t make a big deal about correcting them.
As the disease progresses, it’s important to create a positive environment.
· Allow your loved one to tell stories even if they repeat the same story over and over.
· Avoid expressions that can be taken too literally like “Shake a leg” or “Jump into bed.”
· Never argue with someone with Alzheimer’s. It only makes them more confused, angry and frustrated. Think about what you’re arguing about and ask yourself, “Is it life-threatening?” “Is it about going out into a busy street during rush hour?” You must keep safety in mind but if it’s about whether they’re wearing black or brown pants, don’t waste your time or energy.
· Listen sensitively to laments like, “It’s so hard,” “I don’t know what’s going on,” or “I don’t know what to do” and commiserate with the confusion they’re feeling. If you can, laugh together about how ridiculous life can be.
· Try and be at eye level when talking to someone with Alzheimer’s.
· Use short, simple sentences that express one main idea. AD sufferers may have trouble understanding complex language. Pause between sentences to give them plenty of time to understand the information.
· Approach the person slowly and face them when speaking. Be aware of your facial expressions. Your loved one may be able to interpret your mood from them, especially if you’re frustrated with their behavior.
· Eliminate background noise. Have a conversation in quiet surroundings to prevent the individual from being distracted.
· Take whatever time is needed to respond to what your loved one is trying to articulate, ask or share verbally. It can be a frustrating guessing game until the information is finally grasped. Despite the difficulty, it’s important to maintain communication.
· Don’t be demanding. Instead, try humor or cheerfulness. It often helps during difficult moments. Convincing someone to get out of bed or get dressed is easier if you turn it into a game.
· Win their trust. It will often make a task simpler. One way to do this is to spend some time talking prior to undertaking the task at hand. Discuss the weather or another family member to help your loved one relax.
· As the individual becomes more impaired, they lose their ability to understand words. So you may have to say, “Here’s your lunch at this table” rather than “It’s time for lunch.” They also may revert to words from their childhood so “Do you have to go to the bathroom?” may not be as easily understood as “Do you have to pee?”
· Speak in a warm, easy-going, pleasant manner. Use a tone of voice that you’d like others to use with you.
· Keep the pitch of your voice low. Sometimes, when a person doesn’t immediately understand, there’s a tendency to shout. This upsets them and makes communicating more difficult.
· Redirect the person with Alzheimer’s if they’re becoming agitated by moving on to another activity or conversation. That will remove the situation that’s causing the agitation.
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me at 1 pm Saturday when I’ll talk more about what happens in the moderate stage of Alzheimer’s.