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How do you talk to someone who has Alzheimer’s?

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Old records and newspaper clippings can spark memories for your loved one.

No matter how deeply we care about friends or family, Alzheimer’s disease or dementia can make us uncomfortable — especially when we don’t fully understand it.

Seeing your loved one struggle with memory loss, confusion, or the ability to understand situations and surroundings is difficult.

Fortunately, there are strategies for making your time together meaningful.

"Plan activities that focus on past experiences, rote learning and long-term memory," suggests Michelle Kutner, dementia and memory care senior consultant for the Good Samaritan Society.

In addition, she says, "Activities that are mentally stimulating can help improve concentration, language retention and word-finding abilities."

Michelle suggests the following activities that you can enjoy together.

Past experiences
  • Sort familiar objects such as large beads, small toys or craft supplies.
  • Reminisce using items that are most likely to encourage a response, such as an old photo album or a favorite piece of jewelry.
  • Listen to or sing familiar songs and help your loved one recall events or feelings associated with the music.
Mental stimulation
  • Play games with letters and/or numbers.
  • Match cards or colors.
  • Play modified or simplified board games or card games.
  • Work on modified or simplified crossword puzzles.
  • Play word games such as completing phrases, common proverbs, opposites, similes or rhymes.

"It can be a challenge to find an activity that matches a person’s functioning level so that it's not too easy or too difficult, so try not to become discouraged if you don’t find a match immediately," says Michelle. "Allow a sufficient amount of response time during each activity.

"As Alzheimer’s disease progresses, it will become more difficult for your loved one to communicate," she says. "You will need to assume the role of leader and carry more of the conversation."

For some this is a challenge, but there are strategies you can use to enhance your visit.

Find games you can play together, such as matching colors or shapes. Be sure to modify your activities to your loved one's level of functioning.

Communication tips

  • Face the person directly.
  • Allow additional time for the person to respond.
  • Try other forms of communication (such as singing).
  • Share and discuss memories of the past.
  • Follow the person’s lead during discussions and allow the conversation to occur on its own rather than expecting it to happen within a specific time frame.
  • Minimize the use of questions or quizzing, such as, "Do you remember who I am?" Instead, introduce yourself when you talk to them: "Hi Mom, it's your daughter Jennifer."
  • Avoid correcting or arguing. Keeping things positive is more important than facts.
  • If you can’t understand what the person is telling you, try to respond to the emotional context of the conversation.
  • Be aware that periods of silence during the visit are OK.
  • Avoid elderspeak.
What is elderspeak?

Elderspeak is the term used for speaking to older adults in a simplified, childish way. Its features include:

  • Speaking slowly and loudly, or in a sing-song voice
  • Using inappropriately intimate pet names, such as sweetie, honey or dear
  • Using smaller words and shorter sentences
  • Using pronouns like "we" and "us" instead of "you," such as, "How are we doing today?"
  • Asking questions that assume role loss, idleness or powerlessness, such as "Who did you used to be?" or "What did you used to do?"

While many caregivers feel like speaking in a cheerful, simple way or using terms of endearment shows they care or makes them easier to understand, many older adults are less than receptive to this form of language. Studies have shown that even people with mild to moderate dementia react negatively to elderspeak, causing them to act aggressively and reducing their cooperation.

To avoid elderspeak, be sure to speak in a normal tone at a normal pace, using normal words. Refer to the person by their name or the term you've always used to address them (Jane, Mrs. Jones, Mom, Grandma).

Remember, Alzheimer's and other forms of dementia are progressive diseases, so what works one day might not work the next. The trick is to be flexible and patient. It's important to remember that your presence is what matters most to your loved one.

Sources: ChangingAging, Aging Parents Insights, The New York Times

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By Good Samaritan Society staff

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