Recommended thread Compassionate Communication with the Memory Impaired

denah

Registered User
Jul 26, 2011
7
Norfolk
Thank you for this Compassionate Communication. I have just found this site & so needed these wise words as I care for my husband.
 

Grannie G

Volunteer Moderator
Apr 3, 2006
70,353
Kent
Welcome Denah

I hope you find talking Point supportive.

Please post and share your experiences. It`s what helps us get through.
 

worriedson1

Registered User
Jan 30, 2012
1,837
I've just read all this thread, have to say sadly i am guilty of most of the Dont's:(:(

Reading this rest of the thread actually makes me feel like a human being and i do my utmost to help my mother.

"The Guilt Monster" is a vile creature as i know i try my best to care for my mother. i try to be perfect when none of us are.
 

nannychuck

Registered User
Feb 19, 2012
1
Redditch, Worcestershire
Hi,

I am new to Talking Point and already feel as if I am not the monster I thought I was. My husband has vascular dementia, diagnosed about 3 years ago. My grown up children are great and help out as much as they can, but today my youngest daughter and her dad had an argument which was both upsetting for them and for those in the same room. The problem is their personalities are so alike. They are both pigheaded and both think they are always right and know best.

I have been very distressed by the whole thing, and whilst reading up on dementia yet again I found your thread. I found it really interesting and have to say sometimes I am not as understanding and forgiving as I could be. Neither are my children. But I have sent them a copy of the thread which I know will give them further insight into their fathers worsening condition.

Thank you so much for being there and supporting us.
xx
 

ethel

Registered User
Jan 14, 2012
14
devon
Thank You Grannie G

I too have just read this thread and I am guilty of all the DONTS I will print this out and show rest of the family and try much harder to understand. I love my Mum but can be very difficult sometimes But will try harder!!
 

Cecilia

Registered User
Jan 31, 2012
42
Thank you so much. I have sent this link round the family and printed and put it on the carers notice lard. No excuse now for anyone not to use compassionate communication. I am going to laminate it and put it with the two cards I have by the door which explains who and what problems my mum & dad have so new visitors know before they meet them.

Thanks
 

wdfortyplus

Registered User
Feb 23, 2010
54
!!!!

....there is so much we are getting wrong. But some things we do right. Have emailed that to my partner and her sister. I know things are a learning curve.
 

hollycat

Registered User
Nov 20, 2011
1,350
....there is so much we are getting wrong. But some things we do right. Have emailed that to my partner and her sister. I know things are a learning curve.
You are not getting anything wrong or right........like the rest of us you are

LEARNING​

you can't get anything right or wrong when you are learning !

And to really cheer you up, we never stop learning, so we never get anything right or anything wrong, we just learn.

I have just posted this in reply as it has helped me with my attitude towards everything and it seems to work. Hope it helps ?
 

kayjay

Registered User
Mar 8, 2012
9
Good advice

I think I must have done all the "don't"s with my Mum last year......I found it very hard to know what to say....and am now starting to face the same problems with Dad - he's being assessed for dementia at present. I find it so hard to tell the little white lies....I was brought up to be honest, and feel awfully guilty if I deliberately lie. But I guess the thing is to keep him as happy as poss.....it wasn't possible with Mum, she was always upset, and wanting me to do impossible things, which I found dreadfully stressful. When she died in July it was a relief.

I'm looking to get some more counselling, in the hope it will make it easier to deal with Dad as his problems progress.
 

kayjay

Registered User
Mar 8, 2012
9

keywest67

Registered User
Mar 19, 2012
169
Coventry
Really Helpful tips

The following piece was posted a while ago on TP and made a big impression on me. It is something I have referred to time after time and tried hard to follow.

We have many new members who may not have seen it before. Yesterday I posted it on another Thread but thought it might be helpful if it had a Thread of it`s own.

It`s a tall order but an excellent guideline.


Compassionate Communication with the Memory Impaired

by Liz Ayres
A Volunteer of the Alzheimer's Association and Former Caregiver

DON'T
Don’t reason.
Don’t argue.
Don’t confront.
Don’t remind them they forget.
Don’t question recent memory.
Don’t take it personally.



DO
Give short, one sentence explanations.
Allow plenty of time for comprehension, then triple it.
Repeat instructions or sentences exactly the same way.
Eliminate 'but' from your vocabulary; substitute 'nevertheless.'
Avoid insistence. Try again later
Agree with them or distract them to a different subject or activity
Accept blame when something’s wrong (even if it’s fantasy).
Leave the room, if necessary, to avoid confrontations.
Respond to feelings rather than words
Be patient and cheerful and reassuring. Do go with the flow.
Practice 100% forgiveness. Memory loss progresses daily.
My appeal to you: Please.elevate your level of generosity and graciousness.



Remember

You can’t control memory loss, only your reaction to it. Compassionate communication will significantly heighten quality of life.

They are not crazy or lazy. They say normal things, and do normal things, for a memory impaired, dementia individual. If they were deliberately trying to exasperate you, they would have a different diagnosis. Forgive them ... always. For example: they don’t hide things; they protect them in safe places... And then forget. Don’t take ‘stealing’ accusations personally.

Their disability is memory loss. Asking them to remember is like asking a blind person to read. (“Did you take your pills?” “What did you do today?”) Don’t ask and don’t test memory! A loss of this magnitude reduces the capacity to reason. Expecting them to be reasonable or to accept your conclusion is unrealistic. (“You need a shower.” “Day care will be fun.” “You can’t live alone.”) Don’t try to reason or convince them. Give a one sentence explanation or search for creative solutions. Memory loss produces unpredictable emotions, thought, and behavior, which you can alleviate by resolving all issues peacefully. Don’t argue, correct, contradict, confront, blame, or insist.

Reminders are rarely kind. They tell the patient how disabled they are – over and over again. Reminders of the recent past imply, “I remember, I’m okay; you don’t, you’re not. ”Ouch! Refer to the present or the future. (If they’re hungry, don’t inform them they ate an hour ago, offer a snack or set a time to eat soon.) They may ask the same question repeatedly, believing each time is the first. Graciously respond as if it’s the first time. Some days may seem normal, but they are not. They live in a different reality. Reminders won’t bring them into yours. Note: For vascular dementia, giving clues may help their recall. If it doesn’t work, be kind ... don’t remind.

Ethical dilemmas may occur. If, for instance, the patient thinks a dead spouse is alive, and truthful reminders will create sadness, what should you do? To avoid distress, try these ways of kindness: 1) distract to another topic, or 2) start a fun activity, or 3) reminisce about their spouse, “I was just thinking about ______. How did you two meet?” You might even try, “He’s gone for a while. Let’s take our walk now.”

Open-ended questions (“Where shall we go?” “What do you want to eat/wear/do?”) are surprisingly complex and create anxiety. Give them a simple choice between two items or direct their choice, “You look great in the red blouse.”

They are scared all the time. Each patient reacts differently to fear. They may become passive, uncooperative, hostile, angry, agitated, verbally abusive, or physically combative. They may even do them all at different times, or alternate between them. Anxiety may compel them to shadow you (follow everywhere). Anxiety compels them to resist changes in routine, even pleasant ones. Your goal is to reduce anxiety whenever possible. Also, they can’t remember your reassurances. Keep saying them.

Examples

Don’t reason

Patient What doctor’s appointment? There’s nothing wrong with me.”
Don’t (reason) “You’ve been seeing the doctor every three months for the last two years. It’s written on the calendar and I told you about it yesterday and this morning.”
DO (short explanation) “It’s just a regular check-up.”
(accept blame) “I’m sorry if I forgot to tell you.”

Don’t argue

Patient “I didn’t write this check for $500. Someone at the bank is forging my signature.”
Don’t (argue) “What? Don’t be silly! The bank wouldn’t be forging your signature.”
DO (respond to feelings) “That’s a scary thought.”
(reassure) “I’ll make sure they don’t do that.”
(distract) “Would you help me fold the towels?”

Don’t confront
Patient “Nobody’s going to make decisions for me. You can go now ... and don’t come back!”
Don’t (confront) I’m not going anywhere and you can’t remember enough to make your own decisions.”
DO (accept blame or respond to feelings) “I’m sorry this is a tough time.”
(reassure) “I love you and we’re going to get through this together.”
(distract) “You know what? Don has a new job. He’s really excited about it.


Don’t remind them they forget
Patient: “Joe hasn’t called for a long time. I hope he’s okay.”
Don’t (remind) “Joe called yesterday and you talked to him for 15 minutes.”
DO (reassure) “You really like talking to Joe, don’t you?”
(distract) “Let’s call him when we get back from our walk.”



Don’t question recent memory

Patient “Hello, Mary. I see you’ve brought a friend with you.”
Don’t (question memory) “Hi, Mom. You remember Eric, don’t you? What did you do today?”
DO (short explanation) “Hi, Mom. You look wonderful! This is Eric. We work together.”



Don’t take it personally!

Patient “Who are you? Where’s my husband?”
Don’t (take it personally) “What do you mean – who’s your husband? I am!”
DO (go with the flow, reassure) “He’ll be here for dinner.”
(distract) “How about some milk and cookies?” .. Would you like chocolate chip or oatmeal?



Do repeat exactly

Patient "I'm going to the store for a newspaper."
Don’t (repeat differently) "Please put you shoes on."
"You'll need to put your shoes on."
DO (repeat exactly) "Please put your shoes on."
"Please put your shoes on."



Do eliminate "but", substitute "nevertheless"
Patient "I'm not eating this. I hate chicken."
Don’t (say "but") "I know chicken's not your favorite food, but it's what we're having for dinner."
DO (say "nevertheless") "I know chicken's not your favorite food, (smile) nevertheless I'd appreciate it if you'd eat a little bit."

Used with permission from Ellen Warner at Ageless Design
__________________
__________________

As per requests from members: the original source of this information is here

http://www.agelessdesign.com/Library/InfoManage/Zoom.asp?InfoID=296&RedirectPath=Add1&FolderID=104&SessionID={F6D6DF4E-D924-452C-9E03-21D0E8CA0183}&InfoGroup=Main&InfoType=Article&SP=2

Thankyou, i will give a copy of this to the rest of the family and we will do our best to follow it, i think everyones instinct at first is to correct, remind and reason yet its the worse thing we can do, i think we need to concentrate of the distraction technique and reassure as much as possible.
Thanks again
Lisa
 

MISSJM

Registered User
Mar 19, 2012
48
Ireland
So glad I found this. I can see now where I've been going wrong and it only leads to confrontation.

My biggest issue at the moment is that I've discovered only in the past week or two that Mum can't read. It happened when I was allowed take her out of hospital to visit the grave. She stood initially at the wrong grave and later called me over to where she claimed she was standing at a deceased neighbours headstone. It wasn't his, the name wasn't even remotely like his. I then sat back and tested it a bit and realised that she is either pretending she can read or is certainly not seeing what is in front of her but seeing something else. This morning a card arrived in the post and she told me it was from a cousin of hers. I checked it later and it wasn't, again the name not even remotely like that. I get frustrated because I'm concerned.
 

SisterAct

Registered User
Jul 5, 2011
2,255
67
Liverpool, Merseyside
Thank you tp

We were also doing all the donts and this guide was so helpful. Still have our little blips but we are only human.

We take this if Dad has to go in hospital as this has been the most upsetting place for him (and us).
Last time he was in for a week we actually had a nurse thank us. He said he'd learnt so much from the way we handled and spoke to Dad and looking at our copy of Compassionate Communication, how badly he and the rest of the staff had been coping with dementia patients.

Polly x
 

small

Registered User
Jul 6, 2010
110
harrow
Wow, this is a biggie!
I will have to learn more of these strategies. My husband is just becoming harder and harder to live with. I feel like I'm hitting a brick wall in so many directions at the moment that I don't know how to carve out an acceptable life together without me losing the plot or my temper!!
The memory nurse gave me similar advice early on but I felt I was getting swamped by John. He is very authoritarian and very needy at the same time as being unable to make rational decisions or choices. When he insists on an irrational path for BOTH of us so many times a day life gets very wearing and very like a battle field every day.
I will redouble my efforts at distraction and re-phrasing suggestions (he is convinced I'm trying to "rule" his life, while insisting on ordering me around)
I htink the references to things he should remember or things he has ****** up or unravelled, could definately be handled differently.
I also am going to try and print it out for me and the friend who helps look after him.

Let me add my thanks for resurrecting this thread.

Jackie
 

Butter

Registered User
Jan 19, 2012
6,738
NeverNeverLand
we should keep this high up on the list thread with regular positive comments!
It is brilliant - but I do find it demands super powers ....