If you’re in a conversation with someone with a memory problem, hear this:
Don’t test them. Please.
That’s what I heard in I’m Still Here: A New Philosophy of Alzheimer’s Care. And that’s what I’d already learned with my mom.
Unless you’re questioning for a medical evaluation, why make someone with dementia feel even worse about himself than he already does?
Give them the answers for free instead.
Instead of saying, “Do you remember me? Do you know why I’m here?” (maybe they do, maybe they don’t), say, “Hi, Mom! It’s your daughter Lisa. I’m here to sit and visit with you.”
“Don’t test” is the fourth of the Five Rules of Communication from author John Zeisel, Ph.D.:
4. Don’t test!
For a person living with Alzheimer’s, from the very beginning of the illness, posing such questions feels increasingly like a test of memory they are sure to fail.
…Every test is a reminder of failings and losses. Every test increases the person’s feelings of inadequacy.
Why do we test? We test to make ourselves feel better. We want to know that we exist in the person’s mind as we have always existed.
…If we are more interested in the relationship and the person’s enjoyment, we can give him the answers rather than ask questions. This achieves the same results while decreasing anxiety and agitation.
The other 4 rules are:
1. Hear and respond to the other person’s “reality.”
2. Be honest.
3. Always address the person directly.
5. Don’t say “don’t”; divert and redirect instead.
I began I’m Still Here when my mother was alive. She died when I was about ¾ finished with the book. I debated about reopening it.
I’m glad I did.
Because I don’t know if Alzheimer’s is finished with me or not. Probably not. I’m sure to know many more people with it in my lifetime, including a roomful of friends that I hope to visit again soon.
Zeisel’s book puts a very human face on this disease. He centers on how to stay connected in a loving relationship with the person living with Alzheimer’s.
His final chapter “Being in the Present Moment” highlights two gifts that you receive and can give to those with Alzheimer’s (and to anyone else!):
Mindfulness and Compassion
Through compassionately being present, focus on skills and capacities that don’t fade with the disease, such as emotions, the response to touch, facial expressions, music.
And learn to diminish the 4 A’s of Alzheimer’s Disease that are often only secondary symptoms anyway: apathy, anxiety, agitation, and aggression.
Like people with Alzheimer’s do, learn to live in the “point of time” rather than just the “line of time.”
THE LINE OF TIME
Past —> Present Moment —> Future
We are always moving from past to future.
THE POINT OF TIME
Past —> Present Moment <— Future
The present moment represents all moments.
As Zeisel says, an Alzheimer’s diagnosis doesn’t have be seen as an Alzheimer’s sentence.
Throughout the more than decade-long progress of the disease, the person is crying out, “I’m still here.” We all need to start hearing that cry before it fades away completely.
* * *
Who do you need to listen to today?
Give them the gift of your full attention and compassion.
- More on Alzheimer’s
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