Archive for the ‘Alzheimer’s Communication’ Category

Posted on August 13, 2012 - by Nurse Virginia

BEING AN EXTREME CAREGIVER MEANS BEING CONSERVATIVE AND LIBERAL

The Conservative Caregiver

Be conservative in your criticism and in the use of negative words. Words like “stop,” “don’t,” “that’s wrong,” “I already told you that,” and so on and on.

When you have Alzheimer’s disease or another dementia causing illness, your day is full of mistakes. You no longer remember how to go about doing a familiar task.  You may no longer recognize people or your environment causing you to make even more mistakes.

It is very hurtful to have attention drawn to your on-going mistakes. The caregiver who is very frugal and conservative with hurtful words or comments is giving a priceless gift to the elder they care for.

The Liberal Caregiver

Be liberal in your use of positive sounding words and compliments. Use positive words that encourage like: “good job,” “nice,” “looks good,” “I like that,” etc. Be liberal in your supportive words like “thank you,” “I appreciate your help,” etc. Be liberal in your complimentary words like “beautiful,” “pretty,” attractive,” “strong,” “cute,” etc.

Once you start thinking in terms of positive sounding words and you see how really powerful those words can be, being a conservative/liberal caregiver will just come naturally.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on February 8, 2010 - by Nurse Virginia

How to Use Cues to help the Confused Elder Understand What is Happening

Helping the confused elderly through cues.

Oxford Dictionary defines cue as” a signal to do something.”

The cue may be a smell, a touch, a sound, an item, or a visual symbol. Using a full complement of cues through out the day can help the confused elderly understand the environment, and what is happening at any given moment.

A familiar smell can tell the confused elder it is time to eat

A smell can be a cue that is time to eat, if the cue you smell is pot roast.  A smell can stimulate your appetite such as passing a bakery and smelling the cookies, may make you feel like having a cookie. A fragrance such as baby powder cues you that there is a baby around.  The smell of laundry soap cues you that you are wearing clean clothes.

Seeing a symbol works best as a cue, when the symbol looks the most like what it represents. So a picture of a lawnmower will be a better cue than a line drawing of the same mower. A picture of a banana will not be as good a cue for “do you want a banana” as holding out a real banana to the confused elder.

Helping the confused elderly through combining cues.

Putting a favorite hand lotion on the elder’s hands and massaging it in is using the cues of touch as well as smell.  Hearing running water, holding a bath towel and smelling their life long favorite soap, Dove can cue the elder that they are taking a bath.

Communicating with the confused elderly using cues is non-verbal communication. When the elders have lost their “words” and no longer understand what is being said to them. They can still understand what is going on around them, through your cues.

Cues are forms of communication – helping the confused elder do more for themselves, better understand the environment and know what is going on around them, is the reason for offering cues.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com

Posted on July 29, 2009 - by Nurse Virginia

When the caregiver of the confused elderly want to know, “How can I help you understand more?”

Helping the confused elderly through cues.

Oxford Dictionary defines cue as” a signal to do something.”
The cue may be a smell, a touch, a sound, an item, or a visual symbol. Using a full complement of cues through out the day can help the confused elderly understand the environment, and what is happening at any given moment.

A smell can be a cue that is time to eat, if the cue you smell is pot roast. A smell can stimulate your appetite such as passing a bakery and smelling the cookies, may make you feel like having a cookie. A fragrance such as baby powder cues you that there is a baby around. The smell of laundry soap cues you that you are wearing clean clothes.

Seeing a symbol works best as a cue when the symbol looks the most like what it represents. So a picture of a lawnmower will be a better cue than a line drawing of the same mower. A picture of a banana will not be as good a cue for “do you want a banana” as holding out a real banana to the confused elder.

Helping the confused elderly through combining cues.

Putting a favorite hand lotion on the elder’s hands and massaging it in is using the cues of touch as well as smell. Hearing running water, holding a bath towel and smelling Dove soap can cue the elder that they are taking a bath.

 

Communicating with the confused elderly using cues, is non-verbal communication. When the elders have lost their “words” and no longer understand what is being said to them. They can still understand what is going on around them, through your cues.

Cues are forms of communication – helping the confused elder do more for themselves, better understand the environment and know what is going on around them, is the reason for offering cues.

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: How the senior who has Alzheimer’s Disease forgets their words.

Word loss can be predicted for the senior with Alzheimer’s disease.

As a person goes through the stages of this disease they will lose the ability to talk. In the very beginning they have word finding problems, and they start substituting words, when they forget a word. In the mid-stage they may have just a few words and in the late stage many times they have only one word left and it is yes, or no.

Confused seniors no longer understand concept words.

As people with Alzheimer’s disease lose the words they say, they also are losing the ability to understand words. So when working with someone in the mid-stage who has few words saying to them “do you want to have lunch” won’t be understood. This is why Alzheimer’s specialist say to use concrete words and when ever possible show the item.

As a very young child grows they first can identify a banana by seeing a real banana. They then progress to being able to identify a picture of a real banana, then a drawing of a banana and finally they understand the word banana and can be asked if they want a banana without showing them the fruit itself.

Persons with Alzheimer’s disease lose their words and the meaning of the words in the same order they gained those words. So for the person who is losing these words, once again showing them an actual banana and saying do you want a banana will work much better than the word alone.

Help the senior understand by showing.

So when you talk to a person with Alzheimer’s disease, turn “do you want to have lunch” from a question into a statement “let’s have a sandwich” while you show the bread and lunch meat.

Anytime you turn a question into a statement and an idea into something concrete to be seen you will have greater success.

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: The senior’s name is so important, when working with the senior with Alzheimer’s Disease.

Use the name the senior responds to.

Everyone’s name is important to them. Many people have a special significance to their name. They were named after someone in the family, by someone usually their mother. This is the word that people respond to even very late in the disease process.

I remember a woman who had lost all of her words, was total care in all activities of daily living. And as I walked past her in the hall, all I said was “Gracie”, and her head turned towards me. She was at the end of her life and died soon afterwards but till the end she still responded to her name.

Make sure you are using the name that the person still responds to. When caregivers call everyone “Grandma” that person may have long forgotten that they are a grandma. And so much worse, if the caregiver doesn’t really know them and they never were a grandma – how confusing would that be. I have seen elderly women only respond to their maiden name and when living in a nursing home, the home had to use both maiden and married names to identify them.

Everyone deserves the dignity of being called by the right name; take the time to find out that name.

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: 8 Tips for communicating effectively with a senior with Alzheimer’s disease.

8 Steps to better communication with the confused senior:

• Talk slow – people need time to process and understand words. People with Alzheimer’s disease need even more time.
• Make sure you have the person’s attention, make eye contact. This means if the person is in a wheelchair, stoop down or sit down to talk to them at their level – eye level. Standing over someone and talking down to them can be intimidating, or it might make the person think you are speaking to someone else.
• Give one direction at a time. People with Alzheimer’s disease can’t remember several things at a time.
• Use concrete names. Say” please put the plate over here” – don’t say “put it over here” using “it” for plate. Use a person’s name instead of he or she and add the person’s relationship. Instead of “he is parking the car” say “Bob your brother, is parking the car.”
• Remember “please” and “thank yous”. People with Alzheimer’s disease retain courtesy late in the disease process. I have seen people with no language skills left, yet still able to walk. If they bump into you will say “sorry” or “excuse me”, even though they can say nothing else.
• Keep it simple. Don’t use a lot of words when few will do. It might be your way to talk a lot, and the sound of the human voice can be very soothing. But not if the words are expecting something from the person unable to understand and so cause frustration. But informative conversation about the family, the weather, food, anything that doesn’t include questions and require answers, will be positive.
• Don’t argue. In fact if there is a misunderstanding apologize before emotions escalate. If you don’t understand what the person wants or is trying to communicate simply say “I’m sorry, I don’t understand.”
• When things go wrong or mistakes are made, laugh it off. Not in a way where the person might think they are being laughed at – but rather in a way that says, we all make mistakes – this isn’t a big deal.

Let Go – Let God. Keep in mind the big picture see (Let Go Let God) the last chapter of my book Please Get To Know Me – Aging with Dignity and Relevance.

Posted on January 30, 2009 - by Nurse Virginia

Caregiver Tips: Words That Help – When the elder you care for has Alzheimer’s Disease

Positive communication and the confused elder.

 
Just as words can be negative (see: Words That Hurt) words can also be used to make a person feel good about themselves. It can be:
• The way you say it.
• The words you use.
• The body language you show.

The way you say it – say it with a smile.

 
When words are said with a negative voice – if the confused elder has lost their word skills, and no longer understand the word – they only have the tone of the voice to go on. Even a compliment will sound bad if the tone of the voice is negative. When the tone of the voice communicates anger, impatience, and disgust – the person will become very aware of their dysfunction.

When you say something with a smile on your face – it will be communicated into the tone of your voice. It has been proved to take more face muscles to frown than to smile – so give your face a rest and smile.

Avoid negative words – use positive words.

 Avoid words like don’t, no, can’t, and stop. Use words like thank you, good Job, let’s do that together, words that make a person feel positive and helpful. Elders with Alzheimer’s disease want to contribute and be helpful. It is so easy to say “thank you” and build that persons self esteem.

The confused elder can still read body language.
 Crossing your arms, tapping a foot, showing impatience, people with Alzheimer’s disease can read body language very late into the disease process. When the confused elder no longer has verbal skills they can still read the caregiver’s body language.

Talking about the person – in front of them as though they are not there is never appropriate.

Use words that build –not words that tear down and see the difference in the person you are caring for.

Posted on January 30, 2009 - by Nurse Virginia

Caregiver Tips: Words that Hurt, When you are Caring for an elder with Alzheimer’s Disease.

Babies wear diapers the confused elder needs another word.

When the caregiver really gets to know the person they are caring for; who they are, where they have been, what they have done and what they would like to be remembered for, it is much harder to say “Let’s change your diaper.” Babies wear diapers, adults don’t. Elderly people who have had careers, raised children, earned degrees, served in the Armed Forces, don’t when they become incontinent due to Alzheimer’s, aging or illness deserve to be treated like babies.

These very necessary products can be called briefs, underpants, underwear, your protection, whatever word preserves the dignity of the person. Use a product that more resembles normal underwear – that pulls up rather than one that tapes on at the sides when possible.

Bib – a word that treats the confused elder like a baby.

Babies wear bibs, adults wear clothing protectors, napkins, words that describe the purpose or use. When caring for an elder, don’t take that clothing protector and use it to wipe the face of the person you are assisting to eat. That gesture of wiping an elder’s face with something attached to them treats them like a baby. Even when wearing a clothing protector the adult should have a napkin on their lap, which can be then used to wipe a mouth.

Words are powerful, be careful how you use them.

Words have the ability to make the elder feel good about themselves or bad about themselves. There is power in words, the words you choose, the way you say them, the relationship you have with the person you care for.

Protect the dignity of the confused elder you care for. The words you use are so important; choose wisely, it can make all the difference.

Posted on December 25, 2008 - by Nurse Virginia

Caregiver’s Tips: Caregiver approach makes a difference for elderly with Alzheimer’s Disease

Caregiver Approach Affects Behaviors of Persons with Alzheimer’s Disease

When working with elderly with Alzheimer’s disease make sure that you are calm, not in a hurry and able to focus your attention on this individual. Remember that people with Alzheimer’s disease are very much in the moment. So for that moment they are not thinking of the future or the past and you need to be in the moment with them, for what ever task you are trying to accomplish.

Before you approach the elder, have a plan.

If you need supplies for your task have everything prepared.

Always approach a person from the front so that they can see you coming. This is especially true for a male caregiver and a male patient.

Position yourself on the level of the elder. If in a wheelchair squat a little to the side, in front of the person.

Never speak to the person from the back, above or the side of them.

Person’s with Alzheimer’s disease need to have a connection with you before you can interact with them.

SMILE – most important part of your approach.

Say the person’s first name or whatever name they are used to responding to.

Do not touch the person before they are aware of you and you have made that connection.

Establish a connection with the person before you attempt any type of care.

Remember people with Alzheimer’s disease are very sensitive to body language, tone of voice, negative gestures. If what you present to them is negative they will mirror the behavior they see and become negative as well.

Just as children are in the moment, much can be learned from working with a person with Alzheimer’s disease who is living in the moment. When you are in the moment you can experience and enjoy what is happening right now, without the stress of the future.

Safe Approaches for Caregivers when working with someone with Alzheimer’s disease who has Negative Behaviors

Over reactive responses of distress demonstrate the inability to understand, interpret or cope with a real or imagined situation. Identifying the cause that triggered the negative reaction as well developing safe approaches for this person is the key to success. When a behavior, that is triggered by a physical or psychosocial stimulus is anticipated, the use of a distraction can be put in place pro-actively. See Blogs “Communication”