This chapter takes the widest possible interpretation of communication,
acknowledging what linguists and social researchers tell us --that only 30 percent
of human communication is verbal, and the rest is symbolically expressed
through body language, actions, and behaviors. Begin our understanding by
listening to what the person says and responding or interacting kindly.
When you speak with a person who is deeply impaired by Alzheimer's, speak in
sentences that are clear and simple, in a voice that is soft and kind, in a manner
that is unhurried and relaxed. Sharp voices agitate;hurry causes nervousness
and dysfunction; complexity causes intellectual overload, which will bring about a
distress response that could be rage, tears, anxiety, or extreme slowness and
inability to do tasks. Speak on the same level as the person, both literally so you
can be face to face, and figuratively so that you express ideas in a way that can
be easily absorbed.
No one likes to be patronized, and people with Alzheimer's resent it as much as
anyone else. As caregivers we always need to remind ourselves that, just
because people have Alzheimer's disease, it does not mean they are either
insensitive or stupid. They are functionally impaired, not stupid, and they are
often highly aware of their own and other people's feelings. They many
sometimes say thing that we would consider inappropriate and hurtful--
"Oh, you're very fat, aren't you?"--but this is due to unlearning,
the societal inhibitors they were taught when young.
Be sure to approach the person from the front so you can be seen. Surprises
are not welcome in the world of dementia. Speak clearly, give plenty of time for
the other person to respond, and avoid memory questions. To be sure you have
the person's attention, gently place your hand on his or her arm, hand, or
shoulder and be sure you have eye contact. Persons with Alzheimer's often
spend periods of time in altered consciousness and they need to be gently
brought back into the here and now.
It is astonishing how many caregivers think it appropriate to ask a person with
severe memory problems all kinds of questions involving memory. Here is,
unfortunately a typical family dialogue:
"Hi, Ma, how are you? Do you know who I am? No, not, Vonnie, that was your
brother. Why would you think I was your brother, Ma? Do you know the names of
your other children? Huh? Well, what did you do today, Ma? What did you have
for breakfast? Look, do you know who this is? Huh, Ma?"
If this man could accept his mother's Alzheimer's disease, the greeting might be
much less distressing for all concerned if it went as follows:
"Hi, Ma, it's me, your son, Ron. Good to see you. Boy, you look pretty nice today.
Let's see, it's about five now. They'll be bringing your dinner at six, so that
gives me enough time to show you some photos we took last week."
This communication works better because it does not constantly put Ron's
mother to the test. It also considerately supplies linkage and potentially missing
information and it keeps emphasis on the here and now. The photographs will
give Ron a chance to identify other important family members and to remind his
mother that they exist and they love her. The past is a murky country for the
Alzheimer's sufferer and the future has often become unimaginable, but the
present is always with us. Therefore, we can always rely on the present to be a
part of our communication that can be fully shared.
Just as when we meet a stranger at a social gather, we need to introduce
ourselves afresh each time we meet a person with Alzheimer's disease. Here is
another common example of a distressful communication:
"You remember me, don't you? Can you tell me what my name is? Do you
remember what we did last week? We really enjoyed ourselves. Don't tell me
you've forgotten already."
This would be much less distressing rephrased as,
"Hello, Irene, I'm, Sally. I met you last week at the center and we had a lot of fun
dancing together. My goodness, you're a really good dancer, aren't you?"
Relatives too, should learn this social skill of introducing themselves. This will
help to remove some of their distress when their husbands or fathers or mothers
cannot get their names right. It is not personal, not an attack on their
individuality. It is merely due to the disease's attack on the brain of the sufferer.
Memory capacity varies from day to day, literally, and there will be better days
and worse ones.
Conversational chit-chat can remain as a good social skill even among the
deeply afflicted. This can lead distant family members to assume that the person
is in better shape than he or she really is. A typical family miscommunication
along this line might be as follows:
MARY: Mom, this is April on the telephone.
MOM: April?
MARY: Yes, your daughter April. She's my younger sister.
MOM: Well, who are you?
MARY: I'm your oldest daughter. Now, come on, April's here on the telephone.
Mom heads into the kitchen because she has no idea what the word telephone
represents anymore. Mary retrieves Mom and leads her to the telephone. Mom
puts the wrong end of the receiver to her ear and Mary puts it the right way up.
MARY: Say, hi April.
MOM: Hi, April.
APRIL: Oh Mom, it's so good to hear your voice. You sound great. How are you
doing?
MOM: I'm doing fine.
APRIL: So did you go to Henry's for Thanksgiving?
MOM: Yes. [Actually she did not.]
APRIL: That's great. Did you enjoy yourself?
MOM: Yes.
APRIL: Well, Bill and I are fine and...
Two minutes after this conversation ends, Mom has forgotten entirely that there
was a call, and April is telling Bill that Mom sounds fine and she cannot possibly
be doing as badly as Mary always says she is.
A number of other major problems in communication concern memory issues.
We do not really understand how deeply we are tied into our memory structure
until we live with someone who is not. Then we see that the loss of reliable
memory function fractures the whole of life. Caregivers who are confronted by
this often find themselves frustrated , sometimes hurt, and often caught up in
uncomfortable exchanges that result in bad communication. These appear
constantly in the questions raised by caregivers in Alzheimer workshops:
"My dad has no idea what year this is. I think he thinks it's about 1925 and he
calls me by his brother's name. What should I do?"
The major loss in memory dysfunction is knowing what year this is. Memory is
like a ship, anchored to the current year, and when it loses that anchor entirely
we never know from one moment to the next what year that person's memory
has drifted into. To the person with Alzheimer's, memories feel as real as
experience of the here and now.
Rather than designating this as a delusion, it is more useful to consider it as a
loss of reference system. When confronted by a parent whose memory ship may
have floated back to age sixteen in Texas, acceptance can be very calming. If
the son explains that this is 1993 and he is not his father's younger brother, this
information may not be acceptable or understandable. It may seem as if a time
machine has suddenly landed from the future. Experimentation is the answer. If
his father can accept gentle reorienting to the here and now, that is good. If he
does not accept it or seems uninterested, then the son needs to accept his
father's drift of memory.
One area of communication that puzzles and often hurts family members is their
misidentification. A son is thought to be a brother of father; a daughter is called
sister or mother; wives are though to be mother; husbands are called daddy.
These misidentified relatives feel rejected and hurt. However, if they put
themselves into that frustrating Alzheimer brain, they might see that, first, the
ability ot label a person correctly has been destroyed. Second, if the memory
ship has drifted to the past, to premarriage days, then it makes sense that they
cannot be spouse or child in that particular memory picture. Third, when they are
named as the parent, the person is really saying, "I love you and I need you love
and care and protection as a child needs his parent." When they are named as a
sibling, the person is saying, "I know you are very near and related to me."
acknowledging what linguists and social researchers tell us --that only 30 percent
of human communication is verbal, and the rest is symbolically expressed
through body language, actions, and behaviors. Begin our understanding by
listening to what the person says and responding or interacting kindly.
When you speak with a person who is deeply impaired by Alzheimer's, speak in
sentences that are clear and simple, in a voice that is soft and kind, in a manner
that is unhurried and relaxed. Sharp voices agitate;hurry causes nervousness
and dysfunction; complexity causes intellectual overload, which will bring about a
distress response that could be rage, tears, anxiety, or extreme slowness and
inability to do tasks. Speak on the same level as the person, both literally so you
can be face to face, and figuratively so that you express ideas in a way that can
be easily absorbed.
No one likes to be patronized, and people with Alzheimer's resent it as much as
anyone else. As caregivers we always need to remind ourselves that, just
because people have Alzheimer's disease, it does not mean they are either
insensitive or stupid. They are functionally impaired, not stupid, and they are
often highly aware of their own and other people's feelings. They many
sometimes say thing that we would consider inappropriate and hurtful--
"Oh, you're very fat, aren't you?"--but this is due to unlearning,
the societal inhibitors they were taught when young.
Be sure to approach the person from the front so you can be seen. Surprises
are not welcome in the world of dementia. Speak clearly, give plenty of time for
the other person to respond, and avoid memory questions. To be sure you have
the person's attention, gently place your hand on his or her arm, hand, or
shoulder and be sure you have eye contact. Persons with Alzheimer's often
spend periods of time in altered consciousness and they need to be gently
brought back into the here and now.
It is astonishing how many caregivers think it appropriate to ask a person with
severe memory problems all kinds of questions involving memory. Here is,
unfortunately a typical family dialogue:
"Hi, Ma, how are you? Do you know who I am? No, not, Vonnie, that was your
brother. Why would you think I was your brother, Ma? Do you know the names of
your other children? Huh? Well, what did you do today, Ma? What did you have
for breakfast? Look, do you know who this is? Huh, Ma?"
If this man could accept his mother's Alzheimer's disease, the greeting might be
much less distressing for all concerned if it went as follows:
"Hi, Ma, it's me, your son, Ron. Good to see you. Boy, you look pretty nice today.
Let's see, it's about five now. They'll be bringing your dinner at six, so that
gives me enough time to show you some photos we took last week."
This communication works better because it does not constantly put Ron's
mother to the test. It also considerately supplies linkage and potentially missing
information and it keeps emphasis on the here and now. The photographs will
give Ron a chance to identify other important family members and to remind his
mother that they exist and they love her. The past is a murky country for the
Alzheimer's sufferer and the future has often become unimaginable, but the
present is always with us. Therefore, we can always rely on the present to be a
part of our communication that can be fully shared.
Just as when we meet a stranger at a social gather, we need to introduce
ourselves afresh each time we meet a person with Alzheimer's disease. Here is
another common example of a distressful communication:
"You remember me, don't you? Can you tell me what my name is? Do you
remember what we did last week? We really enjoyed ourselves. Don't tell me
you've forgotten already."
This would be much less distressing rephrased as,
"Hello, Irene, I'm, Sally. I met you last week at the center and we had a lot of fun
dancing together. My goodness, you're a really good dancer, aren't you?"
Relatives too, should learn this social skill of introducing themselves. This will
help to remove some of their distress when their husbands or fathers or mothers
cannot get their names right. It is not personal, not an attack on their
individuality. It is merely due to the disease's attack on the brain of the sufferer.
Memory capacity varies from day to day, literally, and there will be better days
and worse ones.
Conversational chit-chat can remain as a good social skill even among the
deeply afflicted. This can lead distant family members to assume that the person
is in better shape than he or she really is. A typical family miscommunication
along this line might be as follows:
MARY: Mom, this is April on the telephone.
MOM: April?
MARY: Yes, your daughter April. She's my younger sister.
MOM: Well, who are you?
MARY: I'm your oldest daughter. Now, come on, April's here on the telephone.
Mom heads into the kitchen because she has no idea what the word telephone
represents anymore. Mary retrieves Mom and leads her to the telephone. Mom
puts the wrong end of the receiver to her ear and Mary puts it the right way up.
MARY: Say, hi April.
MOM: Hi, April.
APRIL: Oh Mom, it's so good to hear your voice. You sound great. How are you
doing?
MOM: I'm doing fine.
APRIL: So did you go to Henry's for Thanksgiving?
MOM: Yes. [Actually she did not.]
APRIL: That's great. Did you enjoy yourself?
MOM: Yes.
APRIL: Well, Bill and I are fine and...
Two minutes after this conversation ends, Mom has forgotten entirely that there
was a call, and April is telling Bill that Mom sounds fine and she cannot possibly
be doing as badly as Mary always says she is.
A number of other major problems in communication concern memory issues.
We do not really understand how deeply we are tied into our memory structure
until we live with someone who is not. Then we see that the loss of reliable
memory function fractures the whole of life. Caregivers who are confronted by
this often find themselves frustrated , sometimes hurt, and often caught up in
uncomfortable exchanges that result in bad communication. These appear
constantly in the questions raised by caregivers in Alzheimer workshops:
"My dad has no idea what year this is. I think he thinks it's about 1925 and he
calls me by his brother's name. What should I do?"
The major loss in memory dysfunction is knowing what year this is. Memory is
like a ship, anchored to the current year, and when it loses that anchor entirely
we never know from one moment to the next what year that person's memory
has drifted into. To the person with Alzheimer's, memories feel as real as
experience of the here and now.
Rather than designating this as a delusion, it is more useful to consider it as a
loss of reference system. When confronted by a parent whose memory ship may
have floated back to age sixteen in Texas, acceptance can be very calming. If
the son explains that this is 1993 and he is not his father's younger brother, this
information may not be acceptable or understandable. It may seem as if a time
machine has suddenly landed from the future. Experimentation is the answer. If
his father can accept gentle reorienting to the here and now, that is good. If he
does not accept it or seems uninterested, then the son needs to accept his
father's drift of memory.
One area of communication that puzzles and often hurts family members is their
misidentification. A son is thought to be a brother of father; a daughter is called
sister or mother; wives are though to be mother; husbands are called daddy.
These misidentified relatives feel rejected and hurt. However, if they put
themselves into that frustrating Alzheimer brain, they might see that, first, the
ability ot label a person correctly has been destroyed. Second, if the memory
ship has drifted to the past, to premarriage days, then it makes sense that they
cannot be spouse or child in that particular memory picture. Third, when they are
named as the parent, the person is really saying, "I love you and I need you love
and care and protection as a child needs his parent." When they are named as a
sibling, the person is saying, "I know you are very near and related to me."
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Following Clues Alzheimer's Communication
Reprinted with permission from Frena Gray-Davidson, from her book,
"The Alzheimer's Sourcebook For Caregivers"
Third Edition, 1999, Published by Lowell House ISBN 0-7373-0131-7
Frena Gray-Davidson Alzheimer's Guide website address http://www.alzguide.com
Reprinted with permission from Frena Gray-Davidson, from her book,
"The Alzheimer's Sourcebook For Caregivers"
Third Edition, 1999, Published by Lowell House ISBN 0-7373-0131-7
Frena Gray-Davidson Alzheimer's Guide website address http://www.alzguide.com
What we have here...
is a failure to communicate...
is a failure to communicate...
 |  |  |  |  |  |  |  |  |  |  |
 |  |  |  |  |  |  |  |  |  |  |
Available on eBooks... by a different author...
Books by Frena Gray-Davidson...
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1331 Jeffco Blvd. Suite 7
Arnold, MO 63010
Office 636-282-5646
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Voice Alert Driveway & Home Alarm
System-6 allows a maximum of six user recorded messages. Each message is
specific to one zone. For instance, zone one could be for a driveway alarm -
“Car coming up the driveway” while zone two could be for a sensor monitoring
the back yard- “Alert! Child by the pool!” Perhaps a third sensor guards a side
entrance against intruders. However, when this PIR detects movement, the base
unit plays “Intruder on patio” and triggers a floodlight using one of four relays
included on the base unit. System-6 can monitor all three zones simultaneously
and still have three additional zones available when needed. Users can alter their
messages and place the wireless sensors wherever they wish.
System-6 allows a maximum of six user recorded messages. Each message is
specific to one zone. For instance, zone one could be for a driveway alarm -
“Car coming up the driveway” while zone two could be for a sensor monitoring
the back yard- “Alert! Child by the pool!” Perhaps a third sensor guards a side
entrance against intruders. However, when this PIR detects movement, the base
unit plays “Intruder on patio” and triggers a floodlight using one of four relays
included on the base unit. System-6 can monitor all three zones simultaneously
and still have three additional zones available when needed. Users can alter their
messages and place the wireless sensors wherever they wish.
IN CASE OF EMERGENCY PHONE NUMBERS
ICE
We all carry our mobile phones with names & numbers stored in its memory but nobody, other than
ourselves, knows which of these numbers belong to our closest family or friends.
If we were to be involved in an accident or were taken ill, the people attending us would have our mobile
phone but wouldn't know who to call. Yes, there are hundreds of numbers stored but which one is the
contact person in case of an emergency? Hence this "ICE" (In Case of Emergency) Campaign
The concept of "ICE" is catching on quickly. It is a method of contact during emergency situations. As
cell phones are carried by the majority of the population, all you need to do is store the number of a
contact person or persons who should be contacted during emergency under the name "ICE" ( In Case
Of Emergency).
The idea was thought up by a paramedic who found that when he went to the scenes of accidents, there
were always mobile phones with patients, but they didn't know which number to call. He therefore
thought that it would be a good idea if there was a nationally recognized name for this purpose. In an
emergency situation, Emergency Service personnel and hospital Staff would be able to quickly contact
the right person by simply dialing the number you have stored as "ICE."
For more than one contact name simply enter ICE1, ICE2 and ICE3 etc. A great idea that will make a
difference!
Let's spread the concept of ICE by storing an ICE number in our Mobile phones today!
ICE
We all carry our mobile phones with names & numbers stored in its memory but nobody, other than
ourselves, knows which of these numbers belong to our closest family or friends.
If we were to be involved in an accident or were taken ill, the people attending us would have our mobile
phone but wouldn't know who to call. Yes, there are hundreds of numbers stored but which one is the
contact person in case of an emergency? Hence this "ICE" (In Case of Emergency) Campaign
The concept of "ICE" is catching on quickly. It is a method of contact during emergency situations. As
cell phones are carried by the majority of the population, all you need to do is store the number of a
contact person or persons who should be contacted during emergency under the name "ICE" ( In Case
Of Emergency).
The idea was thought up by a paramedic who found that when he went to the scenes of accidents, there
were always mobile phones with patients, but they didn't know which number to call. He therefore
thought that it would be a good idea if there was a nationally recognized name for this purpose. In an
emergency situation, Emergency Service personnel and hospital Staff would be able to quickly contact
the right person by simply dialing the number you have stored as "ICE."
For more than one contact name simply enter ICE1, ICE2 and ICE3 etc. A great idea that will make a
difference!
Let's spread the concept of ICE by storing an ICE number in our Mobile phones today!
| The Personal Care Attendant Guide The Art of Finding, Keeping, or Being One by Katie Rodriguez Banister |
