Last month I talked about a lecture that I attended, “Understanding the Person with Dementia: How to Communicate Effectively.” It was presented by Susan Stone who is with the Alzheimer’s Family Day Center (AFDC) in Fairfax, Virginia and does outreach and education. Communicating with a person with Alzheimer’s disease (AD) is a challenge which takes patience and understanding. This is a continuation of her lecture.

As we age, we all experience age-related brain changes, but for Alzheimer’s disease (AD) patients, the changes may be a lot more pronounced. They include:

  • Impaired hearing – especially higher frequencies
  • Lessened ability to determine the location of sound
  • Decreased vision
  • Slower thought processing
  • Slower in adjusting to light changes. (She suggested going into their bedroom earlier and opening the blinds).

Along with age-related brain changes, there are definite communication changes in dementia. They include the following:

  • Word finding problems (initially nouns and pronouns)
  • Frontal lobe damage
  • Word salads (stringing a lot of words together that don’t make sense)
  • Perseveration (repeating words over and over)
  • Mis-naming (but getting close) (An example she gave was someone trying to say Dairy Queen and used the word “king”).
  • Returning to original language (first to learn and last to lose)
  • Loss of ability to recognize and understand words

When approaching a person with dementia, use the person’s name and casually introduce yourself. Approach the person from the front and make sure you have eye contact. Touching the person also helps them to maintain attention. There’s less human touch as a person gets older so touching is important.

Finally, here are tips for initiating conversation.

  1. Speak slowly and clearly. Use e-x-p-a-n-d-e-d speech, but by all means treat them with dignity and not as though they are a child.
  2. Pause at the end of thoughts to give them time to process.
  3. State one request at a time.
  4. Always explain what you are going to do.
  5. Use lots of hand gestures.
  6. Watch the person closely for their reaction. Anxiety leads to anxiousness to regression.

Next month I will continue with more tips.

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Continuing my highlights of Alzheimer’s Care with Dignity by Frank Fuerst, in today’s post I list 6 caregiver products that Fuerst considers specifically helpful for people with dementia. You may be able to get them free or at a reduced cost. Ask your contacts such as members of your support group or see if it’s a Medicare-qualified item.

Consult his guide for a complete list, but the following are those that solved major physical and psychological challenges for him. Having gotten them sooner he feels would’ve prevented a good deal of stress.

  1. Bathroom transfer bench
  2. Geriatric chair
  3. Plastic runner
  4. Hand-held shower
  5. Stair lift
  6. Wheelchair

A bathroom transfer bench is one where two legs remain inside of the tub with suction cups and two legs are outside of the tub.  It comes with a backrest. Since the person remains seated while bathing, a hand-held shower works well. (Hand-held showers work well for cleaning the tub as well).

A geriatric chair is like a wheelchair except that it is larger and more comfortable. Get one with a tray that can swing down and out of the way.

Plastic runners will help to keep your carpet in good condition in case of accidents. They have spikes on the bottom to hold it in place. Not all plastic runners are alike even though they may look alike. Since you need to walk on the runner, a softer plastic might be more  comfortable than a stiffer one. Use them in areas where there are likely to be accidents such as from the bed to the bathroom and in eating areas.

Stair lifts are expensive, but might still be a less costly alternative to other home alterations. Fuerst suggests that you check the Internet. One source is http://silvercross.com for more information. They also sell used equipment and will buy back equipment, but don’t expect to recover much of your purchase price.

Finally, wheelchairs are available everywhere, but if you’ve never ridden in one, they are not exactly comfortable. Be sure to add a cushion, preferably a high quality gel cushion as mentioned in this post.

In my last post, I reviewed Alzheimer’s Care with Dignity by Frank Fuerst. It’s a book that I believe should be at your fingertips. In this post and others to follow, I want to highlight some of the chapters that were especially interesting and helpful. One of the most important members of your team is your doctor and in this post, I highlight how to choose a doctor for Alzheimer’s disease patients. However, Fuerst quotes the Alzheimer’s Association in the June 2006 report to Congress:

When a person under age 65 goes to a doctor with symptoms of dementia, the doctor may not even think of dementia as a possibility or may not know how to diagnose it. As a result, getting an accurate diagnosis can be a long, difficult, and frustrating process.

For Fuerst, it took almost three years and he states:

If one suspects early onset dementia, one should choose a doctor who can distinguish between depression, menopause, and dementia. A neuro-psychiatrist may be more likely to recommend tests that will give a more accurate diagnosis. The best choice for most people is a doctor whom other doctors highly recommend.

What makes an ideal doctor? A Mayo Clinic study suggests the following:

  1. Confident
  2. Empathetic
  3. Humane
  4. Personal
  5. Forthright
  6. Respectful
  7. Thorough

Are there any other traits you could recommend?

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In my last post, I talked about a handy booklet available for caregivers at the Alzheimer’s Family Day Center. I just finished reading another valuable resource, a book by Frank Fuerst, published in 2007, Alzheimer’s Care with Dignity. This is definitely a handbook worth owning for anyone caring for someone with Alzheimer’s disease. Frank Fuerst shares his 17 years of experience caring for this wife. In his Preface, he says:

After doctors diagnosed June Fuerst with early onset Alzheimer’s disease (AD), her husband attended lectures and read every available book and article on the subject. He followed most advice and found what worked, and what did not. He kept daily notes. As the disease progressed, he found himself in uncharted territory and relied on his own creativity and a process of trial and error. He realized that some information he needed was not available from any source.

Alzheimer’s Care with Dignity is not a big book — just over 200 pages — but loaded with helpful information. It’s an amazing book to read, but more importantly, it’s an essential handbook to have at your finger tips. Caregiving for an Alzheimer’s patient is an extremely challenging and daunting task, particularly in the later stages and unfortunately, everyone is different so that the suggestions he makes may not work in your situation. Facetiously, he says of the job:

  • On call — 24 hours each day
  • Regular pay — None
  • Overtime pay — None
  • Holidays — None
  • Sick time — None at night, weekends or holidays
  • Time off — None without a paid replacement
  • Ambidexterity — Mandatory
  • Needing more than two hands — Mandatory

I will introduce other chapters in future posts. If you cannot afford to buy the book, check to see if it’s in your local library.

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