Daily care of an Alzheimer's patient is as much an art as it is a skill. Here are some concrete suggestions to help deal with the behaviors of the Alzheimer's patient.
The Alzheimer’s patient may become argumentative or violent, may try to get away, or may be unresponsive. Underneath may be feelings of fear and vulnerability. The Alzheimer's Association recommends the following, when handling Alzheimer's patients.
Best Ways to Approach the Alzheimer’s Patient
Move slowly when approaching the patient.
Approach patients from the front where they can see you coming, so they do not get startled or surprised.
Once you have approached the person, stand alongside him instead of face to face. Standing face to face can seem confrontational, whereas standing alongside is perceived as supportive.
If the patient is seated, crouch low so that you are looking at her eye to eye.
Do not grab or touch the person, this may feel threatening. Instead, offer your hand so he may take it.
Call the person by name. Alzheimer’s patients remember their own names even very late in the disease. However their married name often disappears from memory.
How to Get the Alzheimer’s Patient to do Daily Activities
When you want the patient to do a task, offer simple choices, (i.e "Would you like to put on your blue or your red sweater?") instead of asking yes/no questions (i.e. "Would you like to get dressed?")
Ask for their help. (i.e. "Will you help me by putting your arm in this sleeve?")
Ask them to try. (i.e. "I know it seems hard but will you give it just one try?")
Break the task down into simple steps. (i.e. don’t say “Let’s go to lunch.” Instead say, “Put your foot down for me." When they've done that go to the next part, i.e. "Lean forward" or "Stand up" or "Let’s walk to the kitchen.”)
Use short, simple, sentences and give concrete information (i.e. "It's time to eat.")
How to Have a Conversation With the Alzheimer’s Patient
Go slow.
Use familiar words and phrases.
Use objects to show what you are talking about.
Be prepared to repeat conversations.
Look at the person and look interested.
Be prepared for emotional outbursts.
How to Deal With Distress in the Alzheimer’s Patient
Remember to approach the person from the front, then step to the side in a supportive stance and offer your hand. Be at eye level.
Try to understand the need or the emotion behind what the person is saying. What are they feeling?
Use “active listening” and empathy. Repeat back to them what they seem to be feeling, i.e. "It sounds like you are sad." "It seems like you don’t like these eggs." "It sounds like you are cold and you need a sweater." Try to understand what they are going through, for example, “I want to go home,” means “I don’t recognize anything around me.”
Don’t argue. Do not try to talk the patient out of their delusion. This will increase their agitation and it will not work.
Try to distract or re-direct the person. “I know you don’t like the eggs. Let’s try some of the bread. Didn’t you tell me you used to enjoy making bread? Tell me about the bread you made.”
Other Skills for Dealing With the Alzheimer’s Patient
Give lots of praise and positive strokes when they help you.
The copyright of the article Caring for Alzheimer's Patients in Caring for Family Members is owned by Lisa C. DeLuca. Permission to republish Caring for Alzheimer's Patients in print or online must be granted by the author in writing.
I think Lisa is only right in the fact that you should never startle any
one when approaching them, however, I think Lisa is wrong in how to handle
the Alzheimer's patient. One of my friends lost his father to Alzheimer's
and my male friend fought tooth and nail with his father and the doctors
told me (not my friend) that the fighting my friend did with his father
kept his fathers mine sharp and kept his father alive a lot longer than if
his father was treated like a baby. So I want to say to people do not treat
the Alzheimer's patient like a baby, challenge them, make them think. Make
them fight for what they want.
Feb 17, 2009 8:26 PM
Lisa C. DeLuca :
While experts will not recommend "fighting" with Alzheimer's
patients, each caregiver relationship is unique. Questions about handling
individual patients should go to the patient's medical doctor. In general,
patients should be encouraged to do as much as they can safely do for
themselves to promote independence and preserve patient dignity.
May 6, 2009 4:20 PM
Guest :
Hi, Lisa. A friends' mother is in the partial care/paranoia stage of
Alzheimers. I think your advice is very helpful and I'm passing it along.
This sentence from your article helped me a lot. You wrote: “I want to go
home,” means “I don’t recognize anything around me.” I can appreciate that.
When my favorite aunt was living with Alzheimers, I had to help myself
with the thought that "she was okay in HER world." Anyway,
thanks for the helpful work you're doing. Take care, Lynn VG
Aug 1, 2009 8:52 PM
Guest :
Hi Lisa, My father lives with me and we found out last year that he had
dementia/Alzheimer's. My father was an argumentative person when he was
younger but as the years went on he changed. The disease has progressed
recently and he sundowns quite early. He will tell me every night he wants
to go home. I tried to explaine he is home, lately I have tried to change
the subject to another topic. He will go right back to he wants to go
home. He has anger out burst in the evening almost like a wind down before
he falls a sleep. What do you say if you can get him to to stair away from
I want to go home.
Aug 2, 2009 5:42 AM
Lisa C. DeLuca :
It is quite common for Alzheimer's patients to say "I want to go
home" when they are already home. They are saying that they don't
recognize their surroundings, it doesn't seem familiar to them. Or they may
be remembering a past home thinking they still live there. You are right
that you can't talk him out of this idea or feeling by telling him he is
home. But distracting from the request isn't working either. Try to
understand the feelings behind the statement: possibly fear, discomfort,
insecurity, confusion. Contact the Alzheimer's Association and they can
give you numerous ideas on how to address this. If his outbursts threaten
his or your safety, get help right away. Never continue in a dangerous
situation.
Aug 2, 2009 5:51 AM
Lisa C. DeLuca :
There's more info on addressing the statement "I want to go home"
in this article:
http://caringforfamilymembers.suite101.com/article.cfm/coping_with_dementia
_symptoms