By Bob DeMarco
Alzheimer's Reading Room
In order to become an effective caregiver there all kinds of things you must learn. Three of the most important are listening, observing, and comparing.
Most people think that they are good listeners. Now this is something I know a lot about having studied communication in college and graduate school. Try taking the listening test some time, more likely than not you will be surprised by the result.
Listening is a skill. An acquired skill. It takes lots and lots of practice to become a good listener.
For example, if you are already thinking about what you are going to say while a person is still talking -- you are not listening. In the case of the Alzheimer's caregiver, if you are getting bent out of shape while they are still screaming you are not listening. You have to learn to become a duck, and you have to view the nonsensical things that Alzheimer's patients say as water. Let it go. The screaming and meanness are part of the disease, the illness -- they are symptoms of the illness.
You have to pay attention to what the Alzheimer's patient is doing -- you need to observe the good and the bad. If you observe closely you will begin to see patterns of behavior. If you see the patterns then the symptoms of the disease will start to make sense. Once you recognize a symptom as a symptom it will be easier to accept the behavior that comes along with Alzheimer's disease. I know this might sound a bit crazy. So let me put it this way. You need to know what is what. You need to understand what it what.
You will also need to learn to compare before Alzheimer's disease behavior to after Alzheimer's disease behavior (after the patient started suffering from Alzheimer's disease).
In other words, is the behavior you are observing part of the disease or is it part of the persons pre Alzheimer's disease behavior? If the behavior is new and different, or if you never saw it before its a symptom of Alzheimer's disease. Its part of the illness and not a part of the person you know.
Here is one thing I learned about Alzheimer's disease. Often the person suffering from Alzheimer's will give you the exact opposite answer of the answer they would have given you pre Alzheimer's disease. This is part of Alzheimer's World. New and different behaviors that really don't make sense.
My mother's new found Alzheimer's behavior use to frustrate me. Now it fascinates me. Alzheimer's disease is pretty interesting when you start to think about and understand it. By the way, I am not saying I like it.
I told you in Part 1 that my mother was meaner than a junkyard dog. In the beginning when she would get mean, I would be mean right back. Once I realized this was only making things worse, I tried reasoning with her. That didn't last long. You just cannot reason with a person that doesn't remember what they said five minutes ago.
After I went through all the strategies I could think of I decided something had to change. It only took me a couple of nanoseconds to determine that Dotty wouldn't be making the change. I finally started to get it right --
something had to change and that something was me.
I finally realized I had to learn an entire new set of communications skills. The skills necessary to communicate with someone suffering from Alzheimer's disease. This wasn't as easy as I thought it would be. I had been communicating as an adult with my mother for more than 40 years. It took me a long time to perfect my newly needed communications skills and to break old embedded habits.
I had to perfect a brand new way of communicating with my mother. Fortunately, I was a lot smarter and I had 40 years of experience of learning how to communicate effectively. So I had a good idea on the what and how of what I needed to do. So all I had to do was start practicing.
Lets start with the word -- No -- as an example. I believe that the favorite word of most people suffering from Alzheimer's disease is NO. Why not. Its short and the easiest word to remember and say.
Like most of you, when my mother would say NO I would fold up and give in. Quit so to speak. Finally it dawned on me. My mother rarely said no to me before Alzheimer's. In fact, the opposite was true. When ever I would say lets do this, or lets do that she would almost always say OK. Yes.
There was also another embedded dynamic that I had to change in learning to deal with the word NO.
I am the child and my mother is the parent. So when your parent tells you NO it usually means no and that is it. I think this helps explain why so many Alzheimer's caregivers still think NO means no when it comes to someone suffering from Alzheimer's disease.
In Alzheimer's World NO has very little meaning.
My mother was saying NO to everything.
Its time to pee -- NO.
Its time to take a shower -- NO.
Come on get out of the car we are going into the store -- NO.
Why don't you go down and visit Jim and Ruth (something my mother did daily for years) -- NO.
Why don't you call Josephine -- NO.
Maybe I should have named Alzheimer's World -- NO World.
Most Alzheimer's patients say no to anything that requires effort. My mother never said NO to -- its time to eat. Keep that in mind for later reference.
Soon enough, I more or less stopped believing my mother when she said NO. In some ways I learned to ignore the word NO. I just don't respond to the word NO. I don't say anything. In fact, I more or less pretended she said Yes.
Now, I don't even bother asking her if she wants to go into the store. I know if I ask her, she is going to say NO. Or make up some excuse that is the equivalent of NO. So why bother.
I don't say anything. I get out of the car, walk around, open the door, and stick my hand out palm up.
On a good day neither of us will say a word. She will just get out of the car. Nonverbal communication seems to work better than verbal communication. The nonverbal communication in this example are all of the actions I take as I get out of the car and the most important nonverbal communication occurs when I stick my hand out, palm up.
Time to pee -- hand out, palm up.
Time to take a shower -- hand out, palm up.
Don't expect this to work the minute you try it. Or even the first many many times. Just keep trying. Keep your mouth shut, don't get all exasperated. Stay positive.
Let me know when it starts working. Better yet, take some notes and write about it.
You'll be very happy when it starts working. In all likelihood this happiness will lead to bigger and better things.
End Part 2.
Insight and Advice
Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,950 articles with more than 95,100 links on the Internet. Bob resides in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room
Alzheimer's Reading Room
In order to become an effective caregiver there all kinds of things you must learn. Three of the most important are listening, observing, and comparing.
Most people think that they are good listeners. Now this is something I know a lot about having studied communication in college and graduate school. Try taking the listening test some time, more likely than not you will be surprised by the result.
Listening is a skill. An acquired skill. It takes lots and lots of practice to become a good listener.
For example, if you are already thinking about what you are going to say while a person is still talking -- you are not listening. In the case of the Alzheimer's caregiver, if you are getting bent out of shape while they are still screaming you are not listening. You have to learn to become a duck, and you have to view the nonsensical things that Alzheimer's patients say as water. Let it go. The screaming and meanness are part of the disease, the illness -- they are symptoms of the illness.
You have to pay attention to what the Alzheimer's patient is doing -- you need to observe the good and the bad. If you observe closely you will begin to see patterns of behavior. If you see the patterns then the symptoms of the disease will start to make sense. Once you recognize a symptom as a symptom it will be easier to accept the behavior that comes along with Alzheimer's disease. I know this might sound a bit crazy. So let me put it this way. You need to know what is what. You need to understand what it what.
You will also need to learn to compare before Alzheimer's disease behavior to after Alzheimer's disease behavior (after the patient started suffering from Alzheimer's disease).
In other words, is the behavior you are observing part of the disease or is it part of the persons pre Alzheimer's disease behavior? If the behavior is new and different, or if you never saw it before its a symptom of Alzheimer's disease. Its part of the illness and not a part of the person you know.
Here is one thing I learned about Alzheimer's disease. Often the person suffering from Alzheimer's will give you the exact opposite answer of the answer they would have given you pre Alzheimer's disease. This is part of Alzheimer's World. New and different behaviors that really don't make sense.
My mother's new found Alzheimer's behavior use to frustrate me. Now it fascinates me. Alzheimer's disease is pretty interesting when you start to think about and understand it. By the way, I am not saying I like it.
I told you in Part 1 that my mother was meaner than a junkyard dog. In the beginning when she would get mean, I would be mean right back. Once I realized this was only making things worse, I tried reasoning with her. That didn't last long. You just cannot reason with a person that doesn't remember what they said five minutes ago.
After I went through all the strategies I could think of I decided something had to change. It only took me a couple of nanoseconds to determine that Dotty wouldn't be making the change. I finally started to get it right --
I finally realized I had to learn an entire new set of communications skills. The skills necessary to communicate with someone suffering from Alzheimer's disease. This wasn't as easy as I thought it would be. I had been communicating as an adult with my mother for more than 40 years. It took me a long time to perfect my newly needed communications skills and to break old embedded habits.
I had to perfect a brand new way of communicating with my mother. Fortunately, I was a lot smarter and I had 40 years of experience of learning how to communicate effectively. So I had a good idea on the what and how of what I needed to do. So all I had to do was start practicing.
Lets start with the word -- No -- as an example. I believe that the favorite word of most people suffering from Alzheimer's disease is NO. Why not. Its short and the easiest word to remember and say.
Like most of you, when my mother would say NO I would fold up and give in. Quit so to speak. Finally it dawned on me. My mother rarely said no to me before Alzheimer's. In fact, the opposite was true. When ever I would say lets do this, or lets do that she would almost always say OK. Yes.
There was also another embedded dynamic that I had to change in learning to deal with the word NO.
I am the child and my mother is the parent. So when your parent tells you NO it usually means no and that is it. I think this helps explain why so many Alzheimer's caregivers still think NO means no when it comes to someone suffering from Alzheimer's disease.
In Alzheimer's World NO has very little meaning.
My mother was saying NO to everything.
Its time to pee -- NO.
Its time to take a shower -- NO.
Come on get out of the car we are going into the store -- NO.
Why don't you go down and visit Jim and Ruth (something my mother did daily for years) -- NO.
Why don't you call Josephine -- NO.
Maybe I should have named Alzheimer's World -- NO World.
Most Alzheimer's patients say no to anything that requires effort. My mother never said NO to -- its time to eat. Keep that in mind for later reference.
Soon enough, I more or less stopped believing my mother when she said NO. In some ways I learned to ignore the word NO. I just don't respond to the word NO. I don't say anything. In fact, I more or less pretended she said Yes.
Now, I don't even bother asking her if she wants to go into the store. I know if I ask her, she is going to say NO. Or make up some excuse that is the equivalent of NO. So why bother.
I don't say anything. I get out of the car, walk around, open the door, and stick my hand out palm up.
On a good day neither of us will say a word. She will just get out of the car. Nonverbal communication seems to work better than verbal communication. The nonverbal communication in this example are all of the actions I take as I get out of the car and the most important nonverbal communication occurs when I stick my hand out, palm up.
Time to pee -- hand out, palm up.
Time to take a shower -- hand out, palm up.
Don't expect this to work the minute you try it. Or even the first many many times. Just keep trying. Keep your mouth shut, don't get all exasperated. Stay positive.
Let me know when it starts working. Better yet, take some notes and write about it.
You'll be very happy when it starts working. In all likelihood this happiness will lead to bigger and better things.
End Part 2.
Insight and Advice
Original content Bob DeMarco, the Alzheimer's Reading Room