How to Talk to a Person with Alzheimer’s: The Fine Art of Redirection
Caring for Caregivers| Author: Mary Webb Walker
My mom, recently diagnosed with early stage Alzheimer’s disease, had no idea her repetitive questions were tormenting me. I was patient the first 15 times, but answered badly to the 16th. “Mom, you’ve already asked me over and over if we’ve ordered yet!”
Repetition — whether it’s questions, stories or actions — is one of the early symptoms of Alzheimer’s. And, it can be maddening for the care partner, family members and friends. Getting through the repetition stage, which thankfully wanes later in the disease, requires more than just patience. You’ll need an effective strategy to communicate with your loved one with built-in techniques to preserve your sanity.
The first step to spending time with a memory-challenged person is to be prepared to leave your own world behind. You’re on Planet Alzheimer’s now and things are different here. For me, one successful approach is what I call the “Fine Art of Redirection.” By actively changing the focus of the memory-challenged person, we can break the repetitive loop. Doing it creatively and compassionately sends the signal that you will not judge, scold, criticize, or laugh at them.
What if you notice repetitious or uncharacteristic behavior in someone who has not been diagnosed with any form of dementia? Check out this article from Better Health While Aging for guidance.
Caring for a loved one with Alzheimer’s disease, or any form of dementia, is often a long haul. When it comes to redirecting conversation, these 10 tips have really helped me spend higher quality time with my mom. I hope they help you, too.
We all want to get through this Alzheimer’s care partner journey with balance and grace, and emerge with our own health intact.
1. Conversation: Keep it simple
Speaking in short sentences will keep conversations simple and more easily followed. Ask yes/no questions vs. open-ended ones. Take a breath before speaking. Smile. Make eye contact.
Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing with the Disease by Joanne Koenig Coste is a timeless resource for communicating with someone diagnosed with Alzheimer’s Disease.
2. Reject reasoning
Don’t frustrate yourself and your memory-impaired loved one by trying to reason. Verbalizing the number of times a question is asked won’t help either. It just leads to frustration on both sides. Although repetitive behavior can drive you crazy, it’s not a character flaw — it’s the new normal for a brain under the assault of Alzheimer’s. Think of a normal brain and imagine it needs Velcro to make memories stick. Your loved one’s brain has no Velcro. That question they just asked you 12 times? There’s no place for it to attach itself.
There’s no place for logic on Planet Alzheimer’s.
3. Focus on the person with Alzheimer’s
Redirect the conversation with a topic that’s all about them — their hobbies, interests, what makes them happy now. People with memory disorders can be hyper-sensitive to moods, so be mindful to stay calm and collected, not frustrated and angry.
4. Label the emotional pattern: The 7 Dwarfs of Alzheimer’s
When my mom is trapped in a repetitive thinking loop, I try to figure out why. What is she really trying to tell me? I’ve created my own 7 Dwarfs of Alzheimer’s to name her emotional patterns and prepare a strategy for each one. Although there are many more than just 7 and they will change throughout the course of the disease, these are the Dwarfs I am dealing with now: Anxious, Scared, Uncomfortable, Frustrated, Confused, Bored, In Pain and Hungry. My mom could have been uncomfortable, anxious or hungry at lunch, prompting her to repeatedly ask if we had ordered. Turns out she was hungry. The “have we ordered” loop stopped as soon as the cheese biscuits arrived.
{The National Institute on Aging has a wealth of resources to help with communication and understanding behaviors.}
5. Reframe the answer
Answering patiently every time is easier said than done. Maybe you already forgot Tip #2 (Reject Reasoning) and your first answer is a logical one. When that fails, try a new tactic. Instead of: “Yes, we’ve ordered,” try something like: “We ordered shrimp.” Or, “We will order when the waiter comes back.” The slight difference could be just enough to cut the loop. You can also use the question as a redirect idea: “You ordered shrimp. Remember when we used to go to the beach and order shrimp every night?” (Although Alzheimer’s victims have impaired short-term memory, many of their past memories are still intact.)
6. Identify patterns of behavior
Does the repetition happen at a certain time of day? Is it precipitated by certain people or places? Is it associated with boredom or anxiety? By identifying triggers that elicit patterns of behavior, you can learn to avoid putting your loved one in situations that push them into a repetitive loop. Or at least you can be prepared to see it coming.
7. Ask for their opinion or enlist their help
People with memory disorders often feel useless and unimportant. Asking what they think or engaging them in a simple task not only redirects —it stimulates self-confidence. If my mom is falling into repetition as we are getting ready to go out, I’ll ask: “Do you like my black sweater with these pants?” If she is agitated while I am making dinner, I’ll enlist her help: “Would you mind helping me set the table?”
8. Touch is key with Alzheimer’s Disease
Connecting through the sense of touch takes on a new level of importance with the memory-impaired. Gently guiding someone to the window with a light touch of the hand can redirect a repetitive activity like pacing. Point out the squirrel in the tree or flowers in bloom, creating a calm moment and stimulating a new conversation topic.
9. Get Outside
People with Alzheimer’s often develop a heightened love of nature. Walks, drives, sitting by water, and lingering in the garden are effective ways of redirecting toward something beautiful and calming. The fresh air and change of scenery can be a gift for both of you.
Check out this article from The Dementia Centre on the benefits of getting someone with Alzheimer’s outside.
10. Embrace Humor
Laughing as often as possible is my favorite redirection tip. Laughter melts frustration and energizes me on the most difficult days. For humor in the midst of the daily trials as an Alzheimer’s care partner, here is some “Alzhumor” courtesy of the Women’s Alzheimer’s Movement.
{Have you read Wonders in Dementialand: An Artist’s Intimate and Whimsical Account of Dementia, Memory Loss, Caregiving and Dancing Gypsies by Suzka Collins? It’s a refreshingly funny look at caring for someone with Alzheimer’s.}
I liked redirecting my mom by pulling out her favorite joke book— the punch line was a surprise every time. Here’s her favorite: Q: What did the termite say when he walked into the bar? A: Is the bar tender here?
Find a way to laugh every day on this challenging care partner journey. It’s great for your coping ability and for your success as Redirection Champ.
Mary Webb Walker is a healthy lifestyle educator focused on brain health and caregivers. After caring for her mom with Alzheimer’s for four years, she co-founded Caregiver Sanctuary, an Alzheimer’s care partner support group. She is also a founder of AccentHealth, a prevention network in U.S. medical waiting rooms. As a Brain Dame, Mary Webb is helping launch Memory Mondays, a social/educational program for people with early stage dementia in Tampa Bay.
Mary now resides in St Petersburg, Florida with her husband, Howard, after living on their boat in Europe for the past five years. While abroad, she coached expatriates on how to enjoy French food and wine without compromising their health, and mentored European friends on how to care for parents with Alzheimer’s.
Follow Mary on LinkedIn and look for more of her care partner wisdom coming soon on Brain Works Kitchen.
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