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April, 2007

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Rule #1 for caregivers
Do not argue with your loved one
Let’s talk about it
by Bonnie Sandler, S.W.
We have been taught from an early age to communicate with others by using logic and reason. When it comes to communicating with a person with dementia, our communications skills need to be adjusted.
The first rule is that you do not argue with an individual with AD/RD. Not only is it pointless since this person no longer can use logic and reasoning, it may also make them agitated and leave you frustrated and angry.
For example, it is lunch time and you are cleaning up at the sink while your loved one, who is still sitting at the kitchen table, asks for lunch. You explain that he just finished his lunch and he can’t still be hungry. You even go one step further and remind him of what you both had for lunch and that he said he was full. That is your reality, not his.
The Alzheimer person finds himself sitting at the table and has an association with food.  He has no memory of having just finished lunch. He doesn’t recognize that he is not hungry. Remember, he is not doing this on purpose to cause you any stress. He is living in the moment. This is his reality, a result of this disease.
Using rational logic and entering into an argument with him because your facts are correct will only aggravate the situation. I refer to this time as ‘entering his world’. You can acknowledge what he is saying by offering to serve him lunch as soon as you finish washing the dishes. There is a good chance that by then he will forget the second lunch.You can distract him by moving into another area of your house and beginning a new activity. Another suggestion is to offer him something small to eat and he may realize that he is not hungry.
Dressing can also be challenging. If your loved one dresses herself in mismatched clothing this may bother you. Suggesting that she change into another outfit may again turn into an argument. If it is not an issue of safety it is best to let it go. You need to adjust your reaction to seeing someone who has always dressed themselves impeccably walking around in mismatched clothes or a sweater that is inside out. You know your loved one the best. If helping change the clothing is welcomed then do so. If you feel that this will be upsetting, leave it be.
All this sounds so simple. It is not. Retraining ourselves to let go of logic and reasoning and finding new ways of communication is difficult. We can understand it intellectually but putting it into practice is a challenge. Family caregivers find it difficult to avoid arguments. Caregivers are often stressed, overworked and fatigued. None of us are saints and in the moment when their day feels overwhelming they will fall into an argument and often feel guilty afterwards knowing that they have upset their loved one.
An Alzheimer’s person will take their cues from your body language, the expression on your face and the tone in your voice. Be patient, gentle and kind but also remember to be kind to yourself. Forgive yourself.
Caring for a person with AD/RD is difficult and draining, especially if you’re not getting enough support and respite.
In a support group you learn from your fellow group members and the group facilitator. You hear what works and what doesn’t. Each Alzheimer’s person is unique. You adjust yourself to the realities of the disease and to the person who you are caring for. Stay educated. Adapting your responses will lead you to a more comfortable place. Reconsider your approach when something is not working. A most helpful communication guideline is to agree, do not argue.
Thanks to all of you who have been  wonderfully kind and supportive of my first article in last month’s Senior Times.  Your encouragement is greatly appreciated.  I invite you to contact me at b.sandler@sympatico.ca

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