Home health aide with client

According to the Alzheimer’s Association, an estimated 6.7 million Americans are currently living with Alzheimer’s dementia, a figure that equates to nearly 11% of the U.S. population over the age of 65. More than 11 million family members provide unpaid home care to these individuals; such care ranges from assistance with household chores, transportation, medication reminders, bathing and dressing to person hygiene, behavioral and mood management and deescalating episodes of agitation and anxiety.

Given demographic trends, Alzheimer’s is a particularly relevant concern to our friends and neighbors in Florida. Diagnoses of Alzheimer’s is expected to growth by approximately 25% in Florida by 2025, and the state is third in country (behind only much larger states of California and Texas) in terms of family caregivers and unpaid home health care provided to individuals afflicted with the disease.

The Department of Health and Human Services has found that compared to family caregivers to seniors without Alzheimer’s, those caring for an elderly parent or spouse with the disease are more likely to report depression and exhibit signs of substantial emotional, physical and even financial stress. This stress is driven by many different factors, and managing, controlling and reducing it can take many different forms.

As a resource to our friends and neighbors, we’ve collected some best practices for communicating with individuals suffering from Alzheimer’s Disease. To be clear, even fully adopted, these tips will not eliminate the stress or frustrations inherent with caring for an individual with Alzheimer’s. Our aim is simply to make a few common interactions slightly less painful for both the elderly individual and the caregiver, and by doing so make someone’s day that much more pleasant.

Tips for Talking to People with Alzheimer’s Disease

  • Engage calmly and with a smile. Living with dementia is sometimes compared to trying to navigate the world in the state others of us experience when we are half-asleep – we are disoriented, don’t see people approaching from a distance, and often feel like we are trying to make sense of things that are coming at us way too fast. A smile tells the individual that everything’s OK and that you’re there to help.
  • Identify yourself and explain what the conversation will be about. Even if the individual should know who you are or the conversation is one you’ve had many times before, like what to eat, being explicit about the context helps the person gather themselves into the moment.
  • Eye contact is incredibly important when you talk to a person with Alzheimer’s. It helps establish connection and allows the person you are talking to feel like you are paying attention to him or her.
  • Using the person’s name as often as possible helps the person’s mind engage with what is being said since they can instinctively tell that it pertains to them. Using the person’s name often establishes connection akin to keeping eye contact.
  • Avoid distractions. Distractions can be anything from a television in the background to children playing nearby. It is best to find an isolated room to talk in to reduce possible distractions and help the individuals keep track of the conversation. Without making the person feel like they are being taken against their wishes, it can be helpful to direct the person to a quieter place in order to have a conversation.
  • Keep conversations on a one-to-one basis. A conversation with more than one person can be confusing to a person with Alzheimer’s or dementia. Speaking to a loved one suffering from the disease in one-to-one settings will help them keep up with the discussion.
  • Be as specific and concrete as possible. Avoid reverences to “it” and other pronouns that rely on context to identify. Speaking this way can be hard to get used to at first because it differs so much from our normal mode of communicating. Use short, familiar words; without realizing it, in normal conversations our brains are automatically playing catchup in deciphering complex words and context clues. Individuals with dementia are not able to keep up with this decoding.
  • Avoid quarrels or disagreements. The individual with Alzheimer’s dementia may well not be able to articulate a coherent explanation of their position, and they may also feel differently about the topic a short time later. Arguments create stress that is often unproductive.
  • Refrain from finishing your loved one’s sentences or other behaviors than may make them feel infantilized. An approach that better preserves their respect is to ask direct questions that might help him or her remember what was said. Try to ask a question related to the conversation that might get them back on track. Similar patience may be required after asking a question – it’s important to give the respondent time to process, think and answer.
  • Rephrase open-ended questions or categorical instructions. Try to remember to ask questions that have choice answers – “Would yo like cereal or eggs?” instead of “What would you like for breakfast?”. Take note and try to avoid categorical words that have sub-steps or imbedded decisions – “Please put your shirt on.” instead of “Please get dressed.”
  • Understand that they may be in a “different place”. They may believe it is some time in their youth or that a loved one who has passed away is still alive. If these memories and beliefs make the person happy, it’s OK to let them indulge, and even to enter that alternative reality with them. 
  • Get creative by using props or pictures or allowing your loved one to do the same.

Important Reminder for Self-Care

None of these tips will move the needle if you are burning yourself out caring for your loved one. According to the CDC, Caregivers for individuals with Alzheimer’s or dementia are up to 53% more likely than non-dementia caregivers and up to 63% more likely than non-caregivers to report chronic health conditions. It is imperative that you put in place the support systems you will need to be able to healthily sustain the role you have taken on.

Find a support group. Seek and accept help from friends and other family members who offer to offload a piece of the caregiving burden, however small. Speak to your loved one’s physician about local resources. Leverage respite care to schedule time to decompress, take care of things for yourself and come back recharged.

If you or your loved one lives in South Florida, please feel free to reach out to one of our care specialists to discuss local support options and other resources available to you as you care for your aging loved one. Whether you are interested in hiring a home health aide with specialized Alzheimer’s and dementia training for in home care services or simply looking for educational materials, we are happy to assist.