18 Oct 2019
Abby thought her mother was joking when the older woman looked up from her breakfast and asked, “Who are you?” Tears welled up in Abby’s eyes. “Mom, I’m your daughter. Don’t you know me?” “No,” replied her mother.
It’s challenging and, many times heartbreaking, for people whose loved ones are experiencing dementia-related memory loss. The way they engage with their loved one requires flexibility and adaptability.
“People have to change their thinking with a person [or a loved one] who has dementia,” explains Melissa Daniels, Memory Care Supervisor at The Osborn’s H.O.P.E. Center in Rye. “[Although] you want that person to know who you are, never try to remind someone with memory loss of things he or she doesn’t remember.”
Karen Bisignano, a Certified Dementia Practitioner and the senior director at My Second Home, an intergenerational adult day program in Mount Kisco, NY, agrees, “There’s an expectation about how the person [you have a relationship with] is going to show up.”
Synapses in the brain firing correctly can lead to moments of lucidity, reminds Jean Gleeson, director of therapeutic recreation at Waveny LifeCare Network in New Canaan, CT. And those are moments to cherish. When the person doesn’t recognize you, “Change the subject and talk about an object in the room. Ask about a favorite flower.”
Abby turned on the television and, within minutes, the elderly woman smiled and asked, “Did you make this cereal? It’s delicious.”
Dementia, from any of the diseases that cause it, affect more than memory and ability, emphasizes Bisignano. “It affects mood, the centers of the brain that say ‘I’m hungry, I’m thirsty, I need to feed the cat,’ etc.”
Other factors affecting mood and reactions include loss of ability, sense of time, place and self, and disorientation. “Most people don’t remember that they can’t remember,” she adds. “You know your brain’s not working, and you don’t know what you’re not remembering.”
Professionals advise against bringing the person with memory loss back to your reality. “Sometimes the person is not having a good day,” says Daniels. Touch is a powerful way to communicate because the person may remember you are someone he or she knows yet be unable to verbalize the connection.
“If the person talks about a deceased friend or family member, take the words to heart and offer to help find that person,” advises Daniels, who cautions against getting hung up on relationship terms if the person exhibits aphasia (loss of words). “If you’re called a friend instead of a family member, it’s okay – as long as the person thinks you mean something to him or her.”
Her mother often asked Abby about her (deceased) brother or when her parents were coming to visit. Abby nodded and said she was making plans; her mother smiled and changed the subject.
Communication becomes frustrating when a loved one talks about a past event as if it was current. Correcting the person can shock them, warns Gleeson, “and can lead to arguing and suspicion in some cases.” Instead of bringing a parent or loved one into your reality, meet the person where they are.
On days when conversing or redirecting is difficult, she advises, “Sit down next to the person and hold his or her hand. Sometimes words get in the way, and touch is a powerful tool.”
It’s best for visitors to stay 30 minutes or less when their loved is becoming agitated (sundowning). With longer visits, the person you’re visiting may want to leave with you, cautions Daniels.
“We love them and the essence of who they are,” affirms Bisignano. “Be with them where they are in the moment, talk about life experience, and recall happy memories. Keep their brains engaged, even if they tell a story from 20 or 40 years ago. Find gratitude in being with the person, and let go of expectations.”