Understanding How Alzheimer’s Disease Changes People— Challenges and Coping Strategies (Part 1 of 3)

Alzheimer’s disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things and think clearly. People with Alzheimer’s disease become forgetful and easily confused. They may have a hard time concentrating and behave in odd ways. These problems get worse as the illness gets worse, making your job as caregiver harder.

It’s important to remember that the disease, not the person with Alzheimer’s disease, causes these changes. Also, each person with Alzheimer’s disease may not have all the problems we talk about in this book.

The following sections describe the three main challenges that you may face as you care for someone with Alzheimer's Disease:

  1. Changes in communication skills
  2. Changes in personality and behavior
  3. Changes in intimacy and sexuality

Each section includes information on how to cope with these challenges.

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1. Challenge: changes in communication skills

Communication is hard for people with Alzheimer’s disease because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they can’t.

It may help you to know more about common communication problems caused by Alzheimer’s disease. Once you know more, you’ll have a better sense of how to cope.

Here are some communication problems caused by Alzheimer's Disease:

  • Trouble finding the right word when speaking
  • Problems understanding what words mean
  • Problems paying attention during long conversations
  • Loss of train-of-thought when talking
  • Trouble remembering the steps in common activities, such as cooking a meal, paying bills, getting dressed, or doing laundry
  • Problems blocking out background noises from the radio, TV, telephone calls, or conversations in the room
  • Frustration if communication isn’t working
  • Being very sensitive to touch and to the tone and loudness of voices

Also, Alzheimer’s disease causes some people to get confused about language. For example, the person might forget or no longer understand English if it was learned as a second language. Instead, he or she might understand and use only the first language learned, such as Spanish.

How to cope with changes in communication skills

The first step is to understand that the disease causes changes in these skills. The second step is to try some tips that may make communication easier. For example, keep the following suggestions in mind as you go about day-to-day care.

To connect with a person who has Alzheimer's Disease:

  • Make eye contact to get his or her attention, and call the person by name.
  • Be aware of your tone and how loud your voice is, how you look at the person, and your “body language.” Body language is the message you send just by the way you hold your body. For example, if you stand with your arms folded very tightly, you may send a message that you are tense or angry.
  • Encourage a two-way conversation for as long as possible. This helps the person with Alzheimer’s disease feel better about himself or herself.
  • Use other methods besides speaking to help the person, such as gentle touching to guide him or her.
  • Try distracting someone with Alzheimer’s disease if communication creates problems. For example, offer a fun activity such as a snack or a walk around the neighborhood.

To encourage the person with Alzheimer's Disease  to communicate with you:

  • Show a warm, loving, matter-of-fact manner.
  • Hold the person’s hand while you talk.
  • Be open to the person’s concerns, even if he or she is hard to understand.
  • Let him or her make some decisions and stay involved.
  • Be patient with angry outbursts. Remember, it’s the illness “talking.”
  • If you become frustrated, take a “timeout” for yourself.

To speak effectively with a person who has Alzheimer's Disease:

  • Offer simple, step-by-step instructions.
  • Repeat instructions and allow more time for a response. Try not to interrupt.
  • Don’t talk about the person as if he or she isn’t there.
  • Don’t talk to the person using “baby talk” or a “baby voice.”

Here are some examples of what you can say:

  • “Let’s try this way,” instead of pointing out mistakes
  • “Please do this,” instead of “Don’t do this”
  • “Thanks for helping,” even if the results aren’t perfect

You also can:

  • Ask questions that require a yes or no answer. For example, you could say, “Are you tired?” instead of “How do you feel?”
  • Limit the number of choices. For example, you could say, “Would you like a hamburger or chicken for dinner?” instead of “What would you like for dinner?”
  • Use different words if he or she doesn’t understand what you say the first time. For example, if you ask the person whether he or she is hungry and you don’t get a response, you could say, “Dinner is ready now. Let’s eat.”
  • Try not to say, “Don’t you remember?” or “I told you.”

Published by the National Institute on Aging

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