Submitted by Stephanie Duna, Program Services Coordinator and Kathleen T. Malloy, Senior Marketing Director-Arden Courts of Warminster-Alzheimer’s Assisted Living

First of all, always treat people who have Alzheimer’s disease (AD) or related memory impairment with dignity and respect. Although this disease can create childlike behaviors, remember that these individuals are adults and treat them as such. Use their preferred names - avoid honey or sweetie.

Below are some tips on how to have meaningful interactions with individuals with AD or related memory impairment.

1. Do not ask open ended questions or current information questions: Asking open ended or current topic questions will quickly frustrate individuals suffering from Alzheimer’s disease (AD) because it can be difficult or impossible for them to answer. When asking a question, give two answers for the individual to choose from and feel free to hint or guide the individual toward the correct answer. If a wrong answer or a piece of information is given do not correct the individual. As much as you may know the individual is incorrect, they are quite certain they are right. Avoid arguing or angered feelings. Anyone suffering from AD should always feel they are correct.
   
   
2. Focus on what remains: Remember, the knowledge an AD patient retains will constantly change. What generally remains for AD patients is explained as the “first in and last out theory” of human instincts. In other words, the first things individuals learn is usually the last thing they forget. For example, individuals with AD typically will progress to an infancy stage - usually remembering where they grew up rather than where they are living now. Generally, the younger something is learned, the longer it is retained during life. Topics that are successfully recalled because they were learned at a young age include prayer, music, simple math, geography, nursery rhymes (presented in an adult manner) and reading (but not comprehension).
   
   
3. Human Instincts: Be mindful of the “Fight or Flight Theory”. Make sure you always give the individual with AD a feeling of dominance. Stand slightly to their side and always be at an equal or lower height. If someone is sitting, sit next to them. If they are in a wheelchair, bend so you are at eye level. Try using human nature to help achieve a positive interaction. Mimicking can also be a useful instinct to rely on. Most of us instinctually mimic others to fit in. Individuals with AD will do the same.
   
   
4. Body Language: Up to 93% of all communication is non- verbal. Language and word meaning are lost during the progression of AD. Remember that even though an individual can no longer verbalize their thoughts, they may still be able to understand what is being said to them and about them.
   
   
5. Control the conversation: Control your conversations in subtle ways. Have a sense of what you are going to discuss with the individual, but always be prepared with a Plan B. Some good Plan B topics to keep the conversation positive include: children, animals, vacations and past occupations.
   
   
6. Avoid negative topics such as war or weather related catastrophes: This can cause the individual to become anxious or agitated. Individuals with AD have difficulty controlling their emotions and can easily become focused on negative information and even personalize events. Instead, discuss current events such as the birth of a child or a sporting event.
   
   
7. Redirection: Use redirection when someone suffering from AD is focused on the negative or on any undesirable topics. Try to get the individuals attention, and draw them away from the undesired thought. For example: A resident is focused on a locked door. Try saying, “Oh, John-are you trying to go out that door? Me too!-but I need something to drink first because I am so thirsty. Will you please come with me to get a drink and then we can go together.” Once a resident is away from the door for a drink, use any positive task or topic to keep them occupied and not focused on the negative thought.
   
   
8. Validation Therapy: If an individual cannot be redirected, validate their feelings! Avoid correcting them and let the individual think that you are agreeing with them. Make sure the individual knows you are on their side and validate their emotions. Once they become calmer, redirect them again. For example: For the resident focused on a locked door, try saying, “Oh, John, are you trying to leave too? I can’t believe that door is locked- that’s so frustrating! I think I know who can open the door-come with me and we can find him together.” Once the individual is away from the door, try to change the topic. Out of sight-out of mind!