First off, we have to define what dementia is. Most people assume that dementia and Alzheimer’s are the same. They are not! Dementia is an umbrella term which is defined as a group of symptoms that affects one’s memory, language, executive function, perception and behavior. If a person has at least two of the listed symptoms, they are said to have dementia. Alzheimer’s, on the other hand, is the most prevalent form of dementia, and is caused by brain cell death. Alzheimer’s is defined as a progressive disease of the brain which slowly causes impairment in memory and cognitive function.
Memory is important to maintain a healthy brain. Short-term memory loss is an early symptom in people affected with dementia and Alzheimer’s. There is a significant deterioration of the brain size, meaning that important areas of the brain shrink due to lack of use. The damage to the brain results in lost connections between cells, therefore, those with the condition cannot have access to the prefrontal cortex of the brain which controls emotions and reasoning. With cognitive controls being stripped away, it is difficult for those with dementia and Alzheimer’s to define who they are and the environment they are in. They seem to get agitated when they can’t define their own purpose in life. All the crosslinks and memory of their lives become not only mystery to themselves, but the perception of self also becomes a blur.
An important body part that regulates and fires cognitive stimulation is the hippocampus. This particular organ is located in the brain’s medial temporal lobe which regulates emotions and assists with the storage of long-term memory. Alzheimer’s disease has been proven to have affected and damages this area of the brain due to the size of the hippocampus. Although the hippocampus deteriorates with age, it also has the ability to change its own volume (size). To maintain a healthy hippocampus and to keep its normal size, diet, exercise, and brain games are necessary. When cognitive emotions, such as depression, isn’t handled well, the hippocampus will shrink. This shrinkage will then eventually lead to Alzheimer’s where brain cells will be lost.
Speaking to people with Alzheimer’s can be a challenging task. Redirection and changing the narrative is key! The first step in communicating with someone who has Alzheimer’s is to establish a trusting relationship. If you can connect with them emotionally, they are most likely to remember you and will have more feelings of trust with you. With each interaction, both client and caregiver are designed to remember emotional experiences. It is also important to know what agitates your client. Although every situation is different, saying something that is not true, but in a kind manner, usually alleviates tension.
Below are some communication tips:
- Say “yes” to every request unless you are being accused
- Example: Client requests to go home
- Your response should not be “Let’s go!” instead give little information as possible.
- You may say, “I’ll look into that. But first let’s go grab some food first.”
- You would want to distract them (buy time) but also promote a calm environment.
- Beg forgiveness (Accept blame)
- Use touch or gestures
- Example: Touching the upper arm to show you care
- Use a calm voice
- Use simple language and speak slowly
- Do not reason or over-explain
- Use 7 words only to make your point, over-explaining will only make clients more agitated.
- Some examples:
- I will look into that.
- I wondered about that.
- Yeah, you may be right.
- That’s an idea.
- Express interest in what the client is talking about
- Don’t interrupt, unless it is necessary
- Focus on feelings
- Do not spend time reinforcing negativity