Care and Trust...continued

Often, those with dementia become wanderers. A familiar stroll around the neighborhood can turn into a misadventure as steps become jumbled and surroundings become strange. This is even worse, of course, when it comes to driving. Those with dementia still want to be independent and driving is of supreme importance. After all, when a license is removed, the opportunity for freedom and social interaction diminishes creating isolation, dependence, and depression.  A good conversation includes these concerns and also potential remedies such as a walking partner or driving services. I also recommend that families contact law enforcement about concerns so that officers can learn walking routines of one who may become lost. A GPS device for shoes and/or an identification bracelet with an emergency number engraved on one side and the health concern on the other are vital.

            I recommend that beginning at age 50, people hold a yearly summit about worries, finances, health issues, purchases, and other transactions. By maintaining an open conversation, when problems do arise, much is already out in the open. No, you do not need to divulge deep secrets, precise monetary subjects, or other private material, but honest talk now alleviates some stress of burdensome conversations later. Perhaps spouses, children, and other significant relations may not agree, but at least they are fully aware of wishes and requests. In later family gatherings, if dementia has appeared, realize that your loved one may not be able to assess multi-step processes and questions. A little at a time, a few subjects on the table, will provide the most positive results. “To be continued” is recommended.

            This should probably have come at the beginning, however, I wanted to emphasize the worthiness of building trust and personal reliability. Hopefully your loved has recognized some cognitive decline – forgetting dates, losing valuables, feeling perplexed about decisions – and has already suggested a complete medical examination by a neurologist or gerontologist. Self-analysis is undoubtedly the best way to pursue the most beneficial health diagnoses. But sometimes, denial is far easier and so you, as the caring and devoted family member, may be the one to broach this somewhat uncomfortable conversation. Knowing that an abrupt refusal may greet you, plunge on accepting that your concern is of utmost significance.

Care and Trust

With holidays approaching and family and friends visiting, it is essential to maintain calm and safety for loved ones with Alzheimer’s disease. There is nothing like a ruckus to set off a fuse; being prepared can circumvent that. The more I have thought about appropriate behavior and reactions toward those with dementia, the more I understand that this is the way we should treat everyone – with dignity and respect.

Always approach a loved one from the front so that eye contact is made and safety is assured.  Speak calmly and evenly with no excess inflection or tones that sound accusatory or gruff. A soft, gentle voice is relaxing and is likely to encourage conversation. Although this conversation may be one way, primarily you speaking, you may find that your loved one engages. While this back and forth conversation may be confusing with responses off topic and strange, the sound resonating from this interaction is precious.

If somewhere during the visit your loved one becomes agitated, frustrated, or angry, again remain calm, nodding in agreement even when you are completely baffled with what is transpiring. Kindness goes a long way in helping comfort someone with dementia. Arguments and raised voices only exacerbate the situation transforming a slightly out-of-kilter moment into a disaster which is difficult or impossible to remedy. You will never “win” an argument with someone with Alzheimer’s disease so relent, throw in the towel, and return to being that serene, supportive friend. You may need to remind other family members to avoid confrontation as well. There may be pressing issue about long-term care and future health choices that need to be discussed, but yelling about these solve nothing.

When the family gathering includes the above-mentioned conversations, be sure to include your loved one. Even in the deepest throes of dementia, the individual still possesses minutes, seconds, even milli-seconds of lucidity. No one likes being talked about or being talked over, so deliver this same dignity to someone with cognitive decline. Those with dementia can be amazing as well as wily, explaining or responding to one idea with clarity and to the next with utter bafflement. Grab the lucid moments and hang on to the treasure that they are.