Alzheimer’s Communication Tips

Video: Tips to Improve Communication with Alzheimer’s Patients

 

Changes in Communication

As Alzheimer’s and Brain Awareness Month continues, we want to discuss a very important topic- communication and Alzheimer’s. As the disease progresses, a person’s ability to communicate gradually diminishes. Changes in communication vary from person to person, but there are several common issues you can expect to see, including difficulty finding the right words and organizing words logically.

 

Effective Communication

If someone you love is living with the disease, you know it can be challenging at times to communicate with them. The video above discusses the following ten tips for effectively communicating with your loved one.

  • Never argue. Instead, listen.
  • Never reason. Instead, divert.
  • Never shame. Instead, distract.
  • Never lecture. Instead, reassure.
  • Never say ‘remember.’ Instead, reminisce.
  • Never say ‘you can’t.’ Instead, remind them what they can do.
  • Never say ‘I told you.’ Instead, just repeat.
  • Never demand. Instead, just ask.
  • Never condescend. Instead, encourage.
  • Never force. Instead, reinforce.

 

Help Make Communication Easier

In addition to these tips, there are steps you can take to help make communication easier, including:

  • Making eye contact and calling the person by name
  • Being aware of things like your tone, how loud your voice is, how you look at them, and your body language
  • Encouraging two-way conversation for as long as possible
  • Using other methods, such as gently touching
  • Distracting the person if communication creates problems

You also want to encourage the person to communicate with you. You can do this by doing things like holding their hand while you talk and showing a warm, loving manner. It is also important to be patient with angry outbursts and remember that it is just the illness talking.

 

If The Person is Aware of Memory Loss

Since the disease is being diagnosed at earlier stages, many people are aware of how it is impacting their memory. This can make communication even more sensitive because they may become frustrated when they are aware of the memory loss. Here are some tips for how to help someone who knows they have memory problems.

  • Take time to listen. They may want to talk about the changes they are noticing
  • Be as sensitive as you can and try to understand it is a struggle for them to communicate. Don’t correct them every time they forget something or say something odd
  • Be patient when they have a difficult time finding the right words
  • Find a balance between helping them find the right words and putting words in their mouth
  • Be aware of nonverbal communication. As they lose the ability to speak clearly, they may rely on other ways to communicate their thoughts and feelings

 

Additional Resources

For more information on Alzheimer’s disease and how it impacts communication, visit the links or reach out to the contacts below:

 

** NIA Alzheimer’s and Related Dementias Education and Referral (ADEAR) Center

800-438-4380 (toll-free)

adear@nia.nih.gov

 

** Family Caregiver Alliance

800-445-8106 (toll-free)

info@caregiver.org

 

** Alzheimer’s Association

Employee Spotlight: Stephanie Meyer, RN

By: Patricia Hudak, RN and Chelsea Cassidy, LCSW 

Stephanie Meyer is a registered nurse and has been with AT Home Care since 2018.  Her nursing career began in 2003 as a Patient Care Technician in the hospital emergency room with Bon Secours Hospital.  Stephanie had a front row seat in this position to see how people were dying, and she knew it could be better.  Stephanie applied for several transfers within the hospital and was uncertain which unit she wanted to be on however she did know that she wanted the dying process to be different.  After speaking with her boss, she transitioned to a hospice RN Case Manager 14 years ago.

Stephanie began educating the medical field and community on hospice and focusing on how people should have a dignified and peaceful death.  She has great compassion for quality of life and individuals experiencing a comfortable death.

A hospice admission nurse is usually the first clinician that the patient or family will meet.  The patient or family will often have an initial conversation about hospice with a marketer or intake coordinator and once they are ready to be evaluated by a nurse for hospice criteria, the admission RN is sent to meet the patient.  There are three main factors to be considered when a patient is being admitted to hospice: (a) a doctor’s order for hospice evaluation and treatment needs to be obtained, (b) the patient needs to meet hospice criteria based on their terminal diagnosis, and (c) the patient/family needs to agree to the hospice philosophy and plan of care (Medicare).

The admission nurse is the storyteller – they are collecting bits and pieces of a patient’s story and helping them see an option to transition from curative care to palliative care.  Stephanie takes each individual story and translates it into a beginning point of care for the entire hospice team.

An admission nurse is collecting the medical, emotional, psychosocial, and spiritual aspects of a patients care.  Stephanie takes this personalized story and turns it into a picture that is not necessarily black or white but filled with parts of gray.

Stephanie beautifully stated, “The medical field, especially hospice, is not black or white.  It is often gray, and I have learned that gray is a very pretty color.”

Stephanie is very thorough in her evaluation and patient assessment.  During this time frame, she is providing education to the patient, family, and the facility staff if a patient resides in a facility.  Stephanie provides active listening which helps to build trust as this is often a big decision for a patient to make about their health.

Part of Stephanie’s role includes completing hospice admission consent paperwork, educating on hospice, calling in medications and DME, and also obtaining approval from the Medical Director and the family if they are not present. Since COVID-19, many families are limited in being able to see their loved ones, especially in a facility. Stephanie often goes above and beyond to help connect the patient and family with one another.

Non-admits can occur when the patient/family are not quite ready for comfort care.  Their mindset and goals are focused on curative treatments or aggressive options.  Families may be experiencing denial and see hospice as a last resort rather than the quality of life it can provide with pain management, physical, and psychosocial support.

Alzheimer’s and dementia diagnosis is one of the top five admission diagnoses for hospice. Showing decline for hospice eligibility can be a challenge for the admission nurse.  Stephanie works closely with the Intake Department as they have the initial conversation with the patient/family and will obtain the necessary orders and medical information to determine a patient’s eligibility.

Stephanie works a seven on / seven off shift Wednesday-Tuesday 9pm-7pm.  This allows her to complete multiple admissions throughout the day.

Self-care can be a challenge for people, especially those that are working as a caregiver, such as a nurse.  Stephanie practices self-care by “wiping her feet at the door.”  She has promised herself to never sacrifice herself spiritually.  She remains mentally and emotionally prepared for each admission by being fully present in the moment.  When she ends her documentation and sends her report, she accepts her part is complete to the best of her ability.

Stephanie is reliable, compassionate, genuine, and accountable.  She has served AT Home Care Hospice in numerous ways.  She courageously went out to take care of patients that were COVID positive without hesitation in the very beginning of the pandemic.  She voiced this is her calling, and when she became a nurse, it was in good times and even during unknown pandemic times.  She consistently shows up to work daily with a positive attitude and a heart to serve regardless of the circumstance.

 

 

Caregiving and Alzheimer’s

Dear Caregiver,

If you are caring for a loved one who is living with Alzheimer’s disease, you do not need us to tell you that it’s not easy. This progressive disease is difficult to cope with – for both the person living with it and their loved ones. People living with Alzheimer’s may become frustrated when they find themselves struggling to do things they used to do without any problem. And it is hard for you, as the caregiver, to watch the person they once were gradually fade away. They may have brief moments of clarity where it feels like they are themselves again; only to break your heart when the moment is gone.

While there is nothing anyone can do or say to “fix” what you and your loved one are going through, we want you to know you do not have to face it alone. The Alzheimer’s Association has an abundance of resources for both those living with Alzheimer’s and their caregivers. There are support and educational programs available for both, as well. Take advantage of these resources. They are there to help make things a little easier.

 

Understanding Alzheimer’s Disease

It all starts with gaining a better understanding of the disease and how it progresses. Alzheimer’s leads to nerve cell death and tissue loss throughout the brain. This results in the brain shrinking dramatically over time which impacts nearly all its functions.

Although scientists are not completely certain what causes cell death and tissue loss in a brain affected by Alzheimer’s, plaques and tangles appear to be the culprits. Plaques form when protein pieces called beta-amyloid clump together, and tangles destroy a vital cell transport system made up of proteins. Plaques and tangles tend to spread through the cortex in a predictable pattern as Alzheimer’s disease progresses, but the rate of progression varies greatly.

 

Early Stage

In the earliest stages, plaques and tangles begin to form in brain areas involved in learning and memory, as well as thinking and planning. In this stage, a person can still function independently but may start to notice they are sometimes forgetting familiar words or where to find everyday objects.

Someone in this stage may struggle to:

  • Think of the right word or name for something
  • Remember the name of someone they just met
  • Remember something they just read
  • Plan or organize things

 

Middle Stage

In the middle stage, more plaques and tangles develop in the regions of the brain important for memory, thinking, and planning. This leads to the development of problems with memory or thinking that are severe enough to interfere with work or social life. In this stage, someone with Alzheimer’s may have trouble handling money, expressing themselves, and organizing their thoughts. Plaques and tangles also spread to areas involved in speaking and understanding speech and the sense of where your body is in relation to objects around you. It is in this stage that many people are first diagnosed.

Symptoms vary from person to person, but may include:

  • Forgetting events or personal history
  • Feeling moody or withdrawn
  • Being unable to recall personal information such as their address
  • Confusion about what day it is or where they are

 

Late Stage

Most of the cortex is seriously damaged by the time someone reaches the late stage of Alzheimer’s disease. By this point, the brain shrinks dramatically due to widespread cell death. Individuals often lose their ability to communicate, recognize family and loved ones, and to care for themselves in this stage.

In this stage, symptoms are severe and may include:

  • Need for around-the-clock personal care
  • Loss of awareness of recent experiences and their surroundings
  • Changes in physical abilities such as walking and eventually swallowing
  • Difficulty communicating
  • Vulnerability to infections, especially pneumonia

 

Resources for Each Stage

The Alzheimer’s Association provides excellent resources for caregivers for each stage. Visit the links below to learn more.

Early-Stage Caregiving 

Middle-Stage Caregiving

Late-Stage Caregiving

Additional Information on Stages and Behaviors

 

Yours truly,

AT Home Care and Hospice

 

 

Hospice and the LGBTQ Community

LGBTQ Aging

A 2020 Gallup study observed Americans’ identification as lesbian, gay, bisexual, or transgender (LGBT), by generation. The findings report that only 1.3% of the Traditionalist generation (born before 1946) and 2.0% of Baby Boomers (born 1946-1964) identify as LGBT. This number increases dramatically over the generations, reaching 15.9% for Generation Z (born 1997-2002). The question is – does the higher percentage of younger Americans reflect a true shift in sexual orientation? Or is it simply reflecting a greater willingness to identify as LGBT?

Although those who make up the younger generations were born into a world where huge progress has been made in the gay rights movement, the older generations of the LGBTQ community experienced much less accepting times. It wasn’t until 1961 that Illinois became the first state in the United States to get rid of its sodomy law. It then took another ten years before 20 more states followed their lead. So even though Traditionalists and Baby Boomers were around to witness the progress that has been made, many may still have the mindset that society will not accept them for who they are.

It is this fear of discrimination that may play a part in their hesitation to seek the help and support they need as they near the end of their life. As a result, the LGBTQ community has been historically underserved by hospice. A 2011 study reported that 20% of LGBTQ seniors that were surveyed did not even reveal their sexual orientation to their primary physician for fear of discrimination. Beyond hospice services for the patient, their grieving partner often misses out on bereavement support as they care for their partner in their final months and days.

 

Resources for the Aging LGBTQ Community

Hospices are now working harder than ever to understand the specific needs of the aging LGBTQ community and to do all they can to accommodate those needs. The National Resource Center on LGBT Aging is a resource center focused on improving the quality of services and support offered to lesbian, gay, bisexual, and/or transgender older adults. Their website includes resources that cover a variety of topics, including end of life decisions. You can also use the interactive map to find resources in your area.

No one should miss out on the benefits of hospice care for any reason, especially for fear of discrimination.

 

Happy Pride Month!

 

 

Alzheimer’s and Brain Awareness Month

June is…

June is Alzheimer’s and Brain Awareness Month. This month-long celebration provides the opportunity to focus on raising awareness for the 50 million people worldwide living with Alzheimer’s and other dementias.

Alzheimer’s Disease

Alzheimer’s disease is a degenerative brain disease and the most common form of dementia. It causes a slow decline in memory, thinking, and reasoning skills. Schedule an appointment with your doctor if you notice any of these ten signs and symptoms:

  • Memory loss that disrupts daily life
  • Challenges in planning or solving problems
  • Difficulty completing familiar tasks
  • Confusion with time or place
  • Trouble understanding visual images and spatial relationships
  • New problems with words in speaking or writing
  • Misplacing things and losing the ability to retrace steps
  • Decreased or poor judgment
  • Withdrawal from work or social activities
  • Changes in mood and personality

Visit the website for the Alzheimer’s Association for more information on these signs and symptoms to be on the lookout for.

Take Action

There are several ways to get involved in Alzheimer’s and Brain Awareness Month! On June 20th, join the cause by celebrating ‘The Longest Day’ through a fundraising activity of your choice! There are a variety of ways to get involved, including virtually and in-person.

So put on your purple gear, share your story of why you go purple, and join the fight to #EndAlz!