A person said to me, “My husband and I can’t have normal conversations at dinner anymore” meaning now that their dinner table includes Mom, who moved in several months ago and has Alzheimer’s. “She has trouble with saying whatever pops into her mind and won’t let us talk.” “Are you talking to her about your day?” I asked, explaining that Mom can’t follow the conversation in current terms. Try asking her about something about her history, I instructed. Maybe then she will be able to join the conversation appropriately. The outcome that evening revealed her mom’s reality being that of an 8-10-year-old sitting at the table talking about her day at school. People with the diagnosis often struggle to follow current conversation and with a short-term memory issue, it becomes even harder. I offered that if she and her husband wanted to talk about their day, after dinner go sit on the back porch, and chat for a bit where it’s quiet, without her present. At dinner, talk about things she wants to talk about and historical subjects.
Another subject that arose recently was that a client’s Dad was talking a lot about a job he had and a place he lived when he was about age 19 or 20 as if it was his current life. The daughters I was speaking to said he goes there often. One of the two daughters said she is often confused where her dad is from a mental and cognitive standpoint. I submitted that I believe her dad is more in a state of being that youngster from that small home town and still working as a coal miner, showing glimpses of her 87-year-old father, than her father who is frequently showing his progressed Alzheimer’s. When you look at the situation from that standpoint, you have a better chance of being in their reality.
Another example is when a person with diagnosis thinks someone is in the bathroom with them, and they are looking in the mirror at a face they no longer recognize. This is why, in memory care communities they put pictures of residents as they were when they were young in the shadow boxes outside of their rooms.
So much of what we know about working with a person with this diagnosis is that if we can truly walk hand in hand with their reality, we will have more moments of joy and better communication with our loved ones.
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