What do I do when my words seem to fail me?
Humans have the amazing capacity to intuitively process, comprehend, and respond to nonverbal cues in their environment. In fact, when engaging in a conversation with another person, your nonverbal language often speaks much louder than your words.
Beyond our vocabulary, which at time feels inadequate or restricting when we are attempting to express deep emotion, we can share our feelings with others through our posture, facial expressions, tone, and movements. Individuals with Alzheimer’s disease are no exception. While they may suffer from an impaired ability to communicate verbally, they often seem to retain their ability to respond to the nonverbal cues around them. A person with Alzheimer’s can still understand their environment- they know if they are being excluded, looked down upon, or otherwise mistreated.
However, as you might imagine, nonverbal communication is a two way street. We must also learn to interpret the cues of those around us. In patients with Alzheimer’s, attention to body language can often reveal the presence of pain or discomfort. Does your loved one seem unable to get comfortable? Do they suddenly get up and pace around the room? Do you ever notice a grimace on their face? If yes, then invite them to talk to you about these things.
Strong nonverbal communication can also be helpful in managing aggression, agitation, or confusion. At times, a simple touch can do much more than a thousand words could ever hope to do. A hug or a gentle touch on the shoulder says “I’m here for you” in the most powerful way imaginable. Be aware of the power of this sort of communication. Even if you feel as though you are not the “touchy feely” type, you will be surprised to see how those around you will open up once you step outside of your comfort zone.
For more information on Alzheimer’s, or any of your other Colorado estate planning questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Denver elder law attorneys.
How can I improve my communication skills and minimize conflict and agitation?
The ability to effectively communicate is vital to any relationship. However, when you are caring for a person with Alzheimer’s, communication can become more challenging. When a person has Alzheimer’s, the disease affects both their ability to process new information and to verbally communicate. This, in turn, can result in substantial frustration on both the part of the individual and the caregiver. As caregivers, we often strive to prevent or minimize this agitation and maximize understanding.
Here are some suggestions that will help you to become a more effective communicator:
-Be aware of your loved one’s level of alertness. Approach them in such a way that they can see you coming. The goal is to avoid startling and, subsequently, embarrassing them.
-Always maintain eye contact.
-Be aware of the sound of your own voice. Try and adopt a more soothing tone. (Remember, the vast majority of our communication comes not from what we say, but how we say it.)
-Practice improving your body language. Smile, lean towards the person who is speaking, and nod occasionally to show that you are paying attention.
-Speak clearly and concisely.
-Ask only one question at a time. Wait for your loved one’s answer before launching into the next question.
-If it is at all possible, offer choices when you are asking questions- “Should we spend the day at the park or at the mall?”
-If it is necessary, introduce yourself.
-If your loved one is struggling to find a word, maintain positive body language, and gently try to help them finish their thought. However, do not presume to know too much. Be respectful always.
-Repetition is a powerful memory aid. Use it as needed.
-Remove background noise that may act as a distraction.
-Offer positive feedback.
-Be respectful of their emotional state. Be empathetic.
-Touch is another important element of nonverbal communication. Offer warm gestures and hugs as much as possible.
-If you find that you are becoming frustrated or irritated, take a time out. Come back to the issue when you and your loved one are in a better state of mind.
-Do not insist on making trivial corrections to your loved one’s speech. This can be hurtful and degrading.
-Learn the difference between command statements and requests.
-Try not to take your loved one’s undesirable behaviors personally.
- When engaging in conversation, slow down! Rushing through a conversation will amplify frustration.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Denver elder law attorneys
What can I do to gain a better understanding of my loved one’s agitation?
While frequent or intense agitation threatens to place a substantial strain on the relationship between an individual with dementia and their caregiver, many professionals working in geriatrics would urge us to think of that agitation, not as an irrational impediment, but as a behavior that is rooted in legitimate emotions. Thus it may be helpful for caregivers to place a greater emphasis on empathy as they strive to comprehend their loved one’s agitation.
As one might imagine, a common source of agitation in those with dementia comes from the feeling that they have not been heard or properly understood. Despite the presence of a disease, those with dementia maintain a fundamentally human desire to connect with those around them. Consider times when you yourself have felt agitated or frustrated. In our own interpersonal relationships agitation often comes from a failure to effectively communicate. We have all felt as though our words, as well as the raw emotions behind them, have been misunderstood or ignored altogether. In a circumstance such as this, it is not a disagreement itself that is most hurtful- it is the failure of others to validate our own emotions and experiences.
Suppose you have, over the last twenty years of your life, compiled an extensive collection of teacups. If, one day, you were to return home from work and find one of those cups in pieces on the floor, you would, more than likely, experience an emotional response. You might cry, scream, or cast blame on yourself or others. However, as you recount this event to your friends, you can sense a very real difference between the person who thinks teacups are silly trinkets and thus assumes a dismissive tone, and the person who, without necessarily understanding the significance of that particular teacup, accepts your emotions for what they are and attempts to work through them with you. Which of these friends would you like to have? Which of these friends would you like to be?
The same idea applies to the individual with dementia. Just as we all want to feel validated in our emotions and in our thoughts, so too does the person with Alzheimer’s. We must remember that, while an event may seem trivial to us, the same perception may not be shared by the person experiencing it. When a person has Alzheimer’s, the day to day activities that we often take for granted become frustrating and threatening. What is simple for us may be a source of great anxiety for another. Be sensitive to these differences. Work to become an unwavering source of comfort, understanding, and support. Practice conveying these principles in your actions and in your speech.
For more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado estate planning attorneys.
My loved one with Alzheimer’s disease is experiencing a lot of agitation. Could this be caused by their medication?
Agitation is a common place phenomenon in many of our daily lives. We experience it while we are stuck in traffic, at the office, and in our homes. However, fortunately for us, we are often able to identify this feeling and cope with it in a (hopefully) constructive way. But, for the person with Alzheimer’s disease, this process becomes a nearly insurmountable obstacle. It is not uncommon for a person with Alzheimer’s disease to experience difficulty when they are trying to understand or express their feelings. This in turn perpetuates the sense of agitation and strains the relationship between the person with Alzheimer’s and their caregiver who is unable to fully comprehend the situation.
Agitation can stem from a number of causes. However, the sudden onset of agitation or a marked change in its intensity could be related to a change in their medicinal regiment - it is not uncommon for people to experience some side effects when changing their doses or changing prescriptions altogether. Consider keeping a record of these types of changes in your loved one and do not hesitate to share your findings with their doctor. If a change is sudden and dramatic, seek the assistance of your physician immediately - but remember, you should not start, stop, or change a medicinal regiment without first consulting your doctor as this may result in a number of complications.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Denver elder law attorneys.
Where can I go to find more information on Pick’s disease?
It can be quite difficult to find good information on Pick’s disease. The National Institute of Neurological Disorders and Stroke describes Pick’s disease as a type of dementia characterized by progressive deterioration of cognition and social skills. This is accompanied by intellectual and lingual impairment as well as the deterioration of memory. While symptoms of this disease can be highly variable from person to person, there are several common symptoms experienced by most everyone who experiences Pick’s disease. These symptoms include emotional flattening or dulling, increased difficulties with thinking and mental exercises, impaired judgment, and loss of memory.
Although Pick’s disease most commonly emerges between the ages of 40 and 60, it has, in some cases, surfaced in people as young as 20 or as old as 80. Brain scans of people with Pick’s disease have routinely revealed atrophy of the temporal and frontal lobes of the brain. Some brain scans have also revealed cellular anomalies in the brain. Despite these commonalities, the cause of the disease is still unknown.
At present there is no cure for Pick’s disease, but there are treatments available that help to alleviate the symptoms of the disease. For more information on current research relating to Pick’s disease you can visit the National Institute on Aging’s website (www.nih.gov/nia).
For more information on Dementia, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado probate attorneys.
How can I better care for A loved one who has both Alzheimer’s disease and Down’s syndrome? How should I respond to their behavioral changes?
Many individuals who have been diagnosed with Down’s syndrome are living longer and fuller lives than would have been imaginable in past decades. However, as those with Down’s syndrome are living longer, a rise in the number Alzheimer’s cases among these individuals has also been recorded. Regardless of your loved ones level of functioning prior to being diagnosed with Alzheimer’s, the impending threat of further mental deterioration from Alzheimer’s disease can be exceptionally difficult to deal with. Due to the fact that individuals with Down’s syndrome often live with their families throughout their adult lives, family units often become accustomed to the individual’s capabilities. However, with the onset of Dementia, those capabilities, along with behaviors and mannerisms, begin to change. Part of this change involves impaired memory and increased difficulties with simple daily actives like getting dressed or helping out with chores. Individuals in this situation often being to isolate themselves from others and tend to resist leaving their home because of intense feelings of anxiety or fear that may arise from an unfamiliar environment.
In this situation, establishing a routine can be vital tool for maintaining their comfort level and self-esteem. Inviting your loved one to contribute to various family tasks at an appropriate level can provide a much need boost for their sense of self-worth. Work to maintain an environment that evokes as little anxiety as possible - this includes limiting the potential for disappointment or failure in activities. Bearing in mind that their level of functioning will change over time, maintain a sense of flexibility and invite other family members to contribute in ways that will help “fill in the gaps.”
As someone who cares for this individual, it is important that you allow yourself to fully experience your grief. You have, in a very real sense, lost a person that you once knew. Work through your feelings of anger, shock, denial, fear, and depression. Keeping a journal or talking with a support group might be helpful for dealing with these emotions. Work towards a state of acceptance, both for your own sake and for the sake of your loved one.
It is important to allow your loved one to function at their own level. If necessary, lower your expectations. If you have not properly dealt with your own grief, and have become stuck in a state of anger or denial, you risk pushing your loved one into situations they are not capable of managing on their own. This will only result in frustration and hurt-feelings for everyone involved. The importance of acceptance cannot be overstated. Continue to engage your loved one in the activities they are capable of handling and do not force them to participate in the ones that they cannot. Sometimes you only need to modify the way in which the person participates in an activity. While they may have once been responsible for setting the dinner table and pouring drinks, they might now be in charge of making sure that a plate and a drink has already been placed at every seat.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado estate planning attorneys.
What Is The Best Environment For A Person Who Is Experiencing The Early Stages Of Alzheimer’s? Should They Continue To Live On Their Own? Or Would It Be Better For Them To Move Closer To Relatives And Caregivers?
If it is at all possible, you should discuss this question directly with your loved one. If they are still able to rationally make their own decisions, ask for their input and carefully consider their thoughts, emotions, and ideas relating to this topic. Consider visiting your loved one in person in order to have this conversation. During your visit, you will be afforded the chance to personally asses their home environment. Think about whether or not you feel comfortable with their living arrangements. Do you think that your loved one might benefit from in-home care? If you decide that in-home care would be beneficial to your loved one, you can get in touch with a geriatric care manager who can look out for your loved one while you are away. If you are not comfortable with this option, or if it is simply not feasible, consider searching for other resources in your loved one’s neighborhood. A social service agency can help you find appropriate resources or facilities to fit your loved one’s needs. If you feel as though your loved one would be better cared for in a facility, you can enlist the help of a geriatric care manager who will visit your loved one regularly and report back to you with an evaluation of their overall wellbeing. A geriatric care manager functions as your liaison and your loved one’s advocate in order to ensure that they are being properly cared for.
If this is not a desirable situation, then discuss the possibility of moving your loved one closer to your home. Discuss living arrangements. Would your love one live in your home? Or would they live in a facility near your home? If they were to live in your home, consider whether or not they may need additional care during the day while you are at work. If additional assistance is required, a social service agency can be a valuable asset to you. A social service agency can provide you with a list of resources in your area such as in-home care and adult daycare facilities. Adult daycare service providers offer meals, group activities, socialization, and day time supervision. Some daycare providers also offer nursing services and transportation services.
Once you have taken the first step of engaging your loved one in this conversation, you will be able to get a better understanding of what environment is best suited to their needs. It is important that you think through this important question together. Do not shy away from it.
As always, for more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado elder law attorneys.
What Do I Need To Know About “Sundowning?”
The term “sundowning” relates to the tendency of those with Alzheimer’s to experience increasing levels of confusion as the day progresses. While the physiological cause of this phenomenon is not yet understood, there are some external cues that are believed to elicit the symptoms of “sundowning.” These cues involve fatigue, low lighting, and the resulting change in shadows throughout the home as the day progresses. As these environmental changes take place throughout the course of the day, the individual with Alzheimer’s experiences an increasing level of confusion. Sundowning is a rather predictable phenomenon in that it tends to surface around the same time every day. It is because of this predictability that both the individual with the disease and their caregiver can take proactive steps to counteract “sundowning.”
To address the most manageable component of sundowning, consider combating fatigue by encouraging short naps in the afternoon or creating a “quiet time” that can be used for relaxation. This can be a valuable time for both the loved one and the caregiver to step back from the morning’s events and recuperate. Consider ambient elements that might promote relaxation. Your loved one will need to be in a comfortable place, like a bed or a favorite recliner. You might play soothing music, create a source of white noise by turning on a fan or a water fountain, light a candle with a mild fragrance, and dim the lights for your loved one. (It may also be wise to alert your loved one to the impending changes in their environment so they do not become alarmed when they notice the dimmed lights.) In this spa-like environment, you might also take the opportunity to give your loved one a soothing hand massage with warm lotion. If you are currently receiving assistance from a volunteer or a secondary care giver, this might be the ideal time to enlist their help so that you can also take advantage of this period of relaxation.
After quiet time is over, make sure that your home environment remains brightly lit for the rest of the day. The goal is to minimize dark shadows that contribute to your loved ones confusion. If your loved one is visiting an unfamiliar place, like a hospital or a relative’s home, pack things that are familiar to them. Bring their nightlights, their favorite pillow or quilt, their radio, or another comfort item that they will be able to identify with.
If sundowning begins despite these measures, try to keep your loved one occupied with another task. If your loved one is actively engaged in a meaningful activity, such as a hobby, this can help to distract them from the setting of the sun.
For more information on Alzheimer’s, or any of your other Denver elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado estate planning attorneys.
Is It Common For A Person Who Is Experiencing The Early Stages Of Alzheimer’s Disease To Begin Losing Their Ability to Verbally Communicate?
In order to answer this question, we must again remind ourselves that the stages and symptoms of Alzheimer’s are unique to the individual experiencing them. Different people with the disease will progress at different rates and experience different symptoms. While symptoms such as memory loss and feelings of frustration, fear, and uncertainty are relatively common, other symptoms are more variable.
While this is not a universal symptom of Alzheimer’s, individuals who do lose their ability to verbally communicate often do so during the middle to late stages of the disease. As Alzheimer’s progresses and the individual’s brain begins to deteriorate, certain bodily functions become impaired. One such bodily function may pertain to the individual’s ability to communicate with others. Early on, this symptom can be detected in an individual’s inability to complete a sentence or find a word that they are looking for. However, as time progresses, speech can deteriorate to the point that it is all together unrecognizable. A person may form complex sentences in which the words have no relative meaning, or they may lose the physical ability to speak overall.
In dementia, as in many neurological diseases, there is always the frightening possibility of miniature strokes. People who are diagnosed with Alzheimer’s disease often experience miniature strokes. Conversely, there are also a number of people who first experience these strokes and then, consequently, develop dementia. In both of these scenarios, a stroke can be responsible for an individual’s loss of speech. In such a situation, speech therapists may be able to work with these individuals and help them regain or improve their ability to speak.
If your loved one experiences a loss of speech early in the course of the disease, you may need to consult your physician. If you are not comfortable with your doctor or the information he provides you with, seek a second opinion. You may also want to get in touch with a specialist. Since miniature strokes can be difficult to detect, even with the help of an MRI, it is important to seek out an experienced neurologist who will also take observable symptoms and family reports into consideration when formulating a diagnosis.
As always, for more information on Alzheimer’s, or any of your other Denver estate planning questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Colorado elder law attorneys.
Should I Tell My Loved One That They Have Alzheimer’s Disease? And How Should I Relate This To The Rest Of The Family?
This is yet another issue that has been the subject of some debate. While there are many professionals who strongly believe that a person with Alzheimer’s should be made aware of their condition as fully as possible, there are other professionals who argue that it would cause the individual too much undue stress and anxiety. However, it could be best to set these professional debates aside. You know your loved one best. What do you think is right? If you tell your loved one about the diagnosis, how will they react? Are they of a more resilient nature? Will being aware of their condition improve their ability to cope? Or are they more likely to suffer from an overwhelmingly negative emotional response? Do you think that there is a legitimate chance that news of their condition might cause them to develop depression or an anxiety disorder?
However, it is important to bear in mind that, if you choose not to tell your loved one about their diagnosis, there is a very good chance that someone else will accidentally slip-up and reveal that information to them. This, as one might guess, could have a devastating impact on the individual’s internal state as well as their feelings towards you.
If you are nervous about the consequences of concealing a diagnosis, and are yet fearful of personally revealing this information to your loved one, you may consider having a conversation with their physician. If your loved one has a good relationship with their doctor, hearing the diagnosis from a trusted authority figure might be easier for everyone involved. After a doctor has discussed the diagnosis with your loved one, and you have provided the necessary emotional support called for in this situation, you should then consider passing on relevant information to other family members. It can be a relief to have everyone on the same page.
Once everyone has been made aware of the situation, you should consider holding a family meeting to discuss the next step in your family’s journey. It is at this point in time that you ought to consider formulating a plan to get your loved one’s financial and legal affairs in order. However, if this is a tense subject among your family members that is likely to result in disputes, it is not necessary to have your loved one present during conflicts. Again, you must consider what is best for their health. If you know ahead of time that it is a very good chance for conflict, set up a time where you can meet privately with your family members to work through your differences. If you need a mediator, or any other legal advisor, get one. Your loved one’s health and happiness is of paramount importance. The necessity of working together for their sake, despite differences among family members, cannot be overstated.
However, amid the legal and technical concerns associated with Alzheimer’s disease, it is important that you do not neglect emotional needs as well. Allow your loved one, your family members, and yourself to grieve in your own ways. Support one another as best as you are able. If your grief becomes overwhelming, consider speaking to a councilor.
For more information on Alzheimer’s, or any of your other Colorado elder law questions, click here to view our Wills and Trusts 101 seminar or call 303-758-0680 to get in touch with one of our Denver estate planning attorneys.