As our population ages, the number of adults struggling with diseases of the older years increases as well. One such disease is Alzheimer's Disease. The chances that we will come into contact with someone who is struggling with this disease are, unfortunately, steadily increasing.
When we do come into contact with someone struggling with this disease, it can be difficult to know how to connect with them. The types of conversations we had previously may no longer be possible due to changes in memory or information processing abilities. If you are a caregiver for someone with Alzheimer's Disease, that can bring communication challenges to the forefront of your everyday lives, greatly impacting your relationship with your loved one. In this article, I'd like to give an overview of some communication strategies and tips to support you in connecting with people struggling with Alzheimer's Disease in the community or in your own life. For further information, I recommend the Alzheimer's Association website at www.alz.org.
It is important to remember that, while the ability of a person with Alzheimer's Diseaseto communicate is greatly impacted, they maintain their sense of self throughout their experience with the disease. Their ability to express themselves through language and to understand language may change, but you can still connect to the essence of who they are.
Alzheimer's Disease affects each person differently. In the early stages, it may shift the person's ability to communicate and they may have troubling finding the word they want to express. It can be helpful to ask whether they want to be helped with words or not, for example, "How would you like to be helped with words? Would you rather I jump in with a word that you may be looking for, or wait and allow some time for you to find it on your own?"1 While it can help to use short sentences to aid in communication, it is important to not "talk down" to the person. 1 Make sure to include them in the conversation and speak directly with them even if their language seems limited. Their ability to understand may be more intact than their ability to express themselves. 2 Communication challenges and worries about making mistakes may lead a person with Alzheimer's Disease to withdraw from conversations. Including them and being sensitive to these feelings can help them engage and feel connected to you.
As the disease progresses, the person may have further problems with language such as increased difficulties finding words, repeating familiar words, inventing words, losing their train of thought, and difficulties following conversations. 1Connecting through ways other than language becomes more and more important. Paying attention to your tone of voice, facial expression, and body language help support the feeling of safety and connection in a conversation. 1While a person with Alzheimer's may struggle to understand your words, they will understand the feeling behind your words. Your frustration and tension will come through just as will your patience and presence. Taking your time in conversations and taking care to notice your own emotions will support a meaningful connection.
The person struggling with Alzheimer's Disease may also communicate more through behaviors or gestures. It can become important to respond to the emotions that seem to be expressed through the behavior rather than the behavior itself. 1This can require you to understand and join their reality in that moment. The facts are less important than the feelings. For example, rather than "Calm down, I am sure your keys aren't really lost", you might say "I hear how upset you are about the keys not being where they usually are. It is so frustrating when that happens! Can I look for them?" 1This type of attention takes patience and insight. Give yourself time and self-care to be able to provide this type of listening and response.
Some other tools that can support a feeling of safety in communication are approaching the person gently, from the front, and at eye level, as well as calling them by name and identifying yourself and your relationship to them. 1 Gentle touch can also feel grounding and caring. As processing information becomes more difficult, it can be helpful to utilize questions that offer choices rather than open ended questions such as "Would you like tea or water?" rather than "What would you like to drink?".1
In later stages of the disease, communicating in ways other than language may become primary. Using our five senses together can support connection, such as listening to music, looking at photographs, spending time outdoors, and noticing smells, tastes, or sensations together. 1The most important thing to remember at any stage of the disease is that it is okay if you don't know what to do or say. 1Your reassuring presence, respect, and caring connection are the most important to anyone in your life, including your friend or family member struggling with Alzheimer's Disease.
1Effective Communication Strategies. (n.d.). Retrieved May 23, 2018, from https://www.alz.org/northcarolina/in_my_community_64912.asp
2Coste, J. K. (2004). Learning to speak Alzheimers: A groundbreaking approach for everyone dealing with the disease. Milsons Point, N.S.W.: Transworld Publishing.
Back to Kesher Program
Amy Small, LICSW, is the new Kesher social worker at the synagogue. Kesher is the congregational outreach program of Jewish Family Service of Rhode Island, funded by the Jewish Alliance of Greater Rhode Island, and currently active at Congregation Agudas Achim, Temple Torat Yisrael, Temple Am David, Temple Emanu-El and Congregation Beth Sholom. Amy may be reached at firstname.lastname@example.org or