Yesterday afternoon, I walked into the spacious room belonging to Mary, a woman with dementia who has few visitors and with whom I've volunteered to spend a little time every week. I greeted her, complimented her on her beautiful turquoise sweater, and shook her hand.
Then I sat down at her little table that was overflowing with books, photographs, the newspaper and other items she wants to keep close at hand. I started off by picking up a small framed photo of Mary with her husband and three children -- two sons and a daughter.
"Tell me about your daughter," I said, using an open-ended question because they have no right or wrong answers. That's a tip I picked up from The Best Friends Approach to Alzheimer's Care by Virginia Bell and David Troxell.
"Oh, her name is Connie," she told me. "She has four children -- two boys and two girls."
She continued, giving me several details about Connie and her family. I then picked up a photograph of Mary and her twin sister, Bernice, and she told me about how they took piano lessons together when they were children. After a few minutes, I asked her if her daughter ever played a musical instrument.
"I don't have a daughter," she said matter of factly.
"Oh," I countered, picking up the family photo again and holding it out for her to see. "You just told me you have a daughter. Here she is."
Mary's face fell and she said very quietly, "I guess I do have a daughter."
I immediately felt sorry for her embarrassment and was disgusted with myself for having pointed out her mistake. I realized I'd just broken one of the cardinal rules for interacting with a person who has dementia. I'd just read it in The Best Friend's Approach that very morning: "Let the person save face."
When relating to a person with Alzheimer's, there are many guidelines to follow. I'm going to discuss five of the most basic ones here: 1) Don't tell them they are wrong about something, 2) Don't argue with them, 3) Don't ask if they remember something, 4) Don't remind them that their spouse, parent or other loved one is dead, and 5) Don't bring up topics that may upset them.
Don't Tell Them They're Wrong About Something: To let the person save face, it's best not to contradict or correct them if they say something wrong. There's no good reason to do that. If they're alert enough, they'll realize they made a mistake and feel bad about it. Even if they don't understand their error, correcting them may embarrass or be otherwise unpleasant for them.
Don't Argue With the Person: It's never a good idea to argue with a person who has dementia. First of all, you can't win. And second, it will probably upset them or even make them angry. I learned a long time ago, when caring for my beloved Romanian soul mate, Ed, the best thing to do is simply change the subject -- preferably to something pleasant that will immediately catch their attention. That way, they'll likely forget all about the disagreement.
Don't Ask if They Remember Something: When talking with a person who has Alzheimer's, it's so tempting to ask them if they remember some person or event. "What did you have for lunch?" "What did you do this morning?" "Do you remember that we had candy bars when I visited last week?" "This is David. Do you remember him?" Of course they don't remember. Otherwise, they wouldn't have a diagnosis of dementia. It could embarrass or frustrate them if they don't remember. It's better to say, "I remember that we had candy the last time I was here. It was delicious."
Don't Remind the Person that a Loved One Is Dead: It's not uncommon for people with dementia to believe their deceased spouse, parent or other loved one is still alive. They may be confused or feel hurt that the person doesn't come to visit. If you inform them that the person is dead, they might not believe it and become angry with you. If they do believe you they'll probably be very upset by the news. What's more, they're likely to soon forget what you said and go back to believing their loved one is still alive. An exception to this guideline is if they ask you if the person is gone. Then it's wise to give them an honest answer, even if they will soon forget it, and then go on to some other topic.
Don't Bring up Other Topics That May Upset Them: There's no reason to bring up topics you know may upset your loved one. If you don't see eye-to eye on politics, for example, don't even bring it up. It may just kindle an argument, which goes again the second guideline above. You won't prevail and it's just likely to cause them anger and/or frustration.
So there you go. A few guidelines for visiting. I hope these will be helpful to you in visiting your loved one and enriching the time you have together.
Marie Marley is the award-winning author of Come Back Early Today: A Memoir of Love, Alzheimer's and Joy. There is a wealth of information for Alzheimer's caregivers on her website, ComeBackEarlyToday.com.