Alzheimer’s Disease is a women’s issue. Here’s why.

January is National Alzheimer’s Disease Awareness Month in Canada.

Increased age is a well-known risk factor for dementia. And since women live longer than men, that makes women more likely to develop dementia.

In fact, women represent 72% of all Canadians living with Alzheimer’s disease. And women represent almost 70% of family caregivers, often caring for a loved one while also working and raising their own families.

These women are our mothers and grandmothers, sisters and wives, friends and neighbours.  Alzheimer’s disease is very much a women’s issue!

Warning signs of Dementia:

  • Memory loss that affects day-to-day abilities, such as mis-placing things.
  • Impaired judgement, such as with finances or self-care.
  • Difficulty performing familiar tasks, such as managing money.
  • Problems following or joining a conversation.
  • Loss of initiative or social withdrawal.
  • Changes in mood and personality, becoming suspicious or anxious.
  • Confusion with time and space, at times forgetting where they are or how they got there.
  • Problems with abstract thinking, taking longer to do things.

The ability to have meaningful communications is one of the many skills that deteriorates as Dementia progresses.

In the early stages….
You may notice mild word finding difficulties, increased hesitations and more repetition of ideas.

In the middle stages…
You will see substantial word-finding difficulties, sentences may be void of meaning, and they are unlikely to initiate conversation.

In the later stages…
They may repeat or echo what others say, become mute, or be unable to understand what you say.

 

Thankfully, as a caregiver, much of your communication with an adult with Dementia can be achieved non-verbally.

A SMILE IS A POWERFUL COMMUNICATION TOOL.  It creates a sense of ease and joy for everyone involved.  And in my opinion, anything that brings ease and joy at times of confusion, uncertainty and frustration, is a gift.

A smile keeps things simple, lets the person know they have done something well, conveys that they have made you happy, provides a sense of safety and comfort.

It is well known that smiles are contagious. If as a result of your smile the adult with Dementia smiles, their smile will elicit more interest and interaction from the people around them. And more interest and interaction equate to more connection, something terribly lacking in the world of Dementia.

Spreading a smile is simple to do. Place yourself in front of the adult with Dementia when they wake in the morning, get on their eye level and smile. If you like, you can hold their hands in yours. Keep up this routine until they smile back.

USE CONSISTENT ROUTINES  to support adults with Dementia. Not only do they like routines, but memory of routines generally lasts well into the middle stages of Dementia.

Routines are those things that happen regularly, often on a daily basis. Common routines are reading the newspaper, folding laundry, going for a walk together, or setting the table for dinner.

Three benefits of using routines:

  1. Creates Ease

Routines are predictable, which helps to avoid confusion and let the person know what is coming next. Predictability creates ease and reduces the number of words a caregiver needs to communicate steps, instructions and reminders.

  1. Maintains Function

Whether it’s a physical or mental task, practicing routines helps maintain function and increase the likelihood of retaining abilities. Performing tasks independently can subsequently increase self-esteem and confidence.

  1. Reduces caregiver stress

Routines keep the day more organized and reduce the likelihood of problem behaviours. When the person with Dementia feels more ease or confidence, caregiver stress goes down.

Are you having trouble explaining Alzheimer’s to your children?

The Remember Balloons is a beautiful book that explains Alzheimer’s Disease and helps children cope with a loved one whose memories are fading.

Helpful strategies to connect with adults who have Dementia

Dementia is one of the biggest public health challenges we face today. With 35 million people living with Dementia worldwide, and the prevalence expected to double every 20 years, it is likely that most of us will be personally touched by Dementia.

Alzheimer’s disease is responsible for almost 50% of dementia. This disease presents unique communication challenges, and often results in social isolation. Depression and further declines in physical health are probable consequences. My main goals, when working with adults who have dementia, are to strengthen their SOCIAL CONNECTIONS.

Here are my top 3 tips for how to best communicate with adults who have dementia.

1. VALIDATE

Adults with dementia often make inaccurate statements. Common reactions include correcting and re-orienting them to the present situation however, repeated correcting may create negative feelings and result in agitation or aggression. Experts say that denying any bad feelings will intensify them so, instead of correcting or arguing, validate their belief, regardless of accuracy. Validation can simply be a mirroring of what they said, commenting on how happy they appear, reassurance, or if they shared something disturbing, acknowledge how difficult it must be.

2. USE CLEAR SPEECH

Speak at a slightly slower rate with a slightly louder volume. Use a full range of intonation, stressing the keywords in your message while adding pauses between phrases and sentences.  Avoid using ‘elderspeak’ characterized by an elevated pitch, a noticeably slower rate and repetition. Studies reveal that ‘elderspeak’ does not improve comprehension, and results in withdrawal and lowered self-esteem.

3. WHEN ASKING QUESTIONS…

Avoid any testing questions, and resist the temptation to check if a loved one remembers a name. Instead, offer reassurances and reminders, such as the date, time and place. You can also introduce yourself and any others who enter the room, regardless of your relationship or how long you have known each other.  

Try to choose questions that support the individual’s spared abilities and avoid questions that rely on impaired memory, such as the events of their day, or dates of significant events. Even in the later stages of dementia, a person can usually reminisce about past life events and relationships; they may remember song lyrics and how to do routine tasks and they can also often answer questions about their feelings and share their opinions. When asking a question, notice how you are asking. For example, questions with choices are easier to answer than open-ended questions.

Give the person with Dementia extra time to respond to your question. You may not get an immediate response, be patient. They need extra time to process spoken information, and repeating your question will interfere with their processing.

These are Connecting Strategies: you are reaching out, recognizing their strengths, and literally meeting them where they are at.  In doing so, you bring ease to the interaction and strengthen the social connection. Considering that the weight of the conversation will fall to you, come prepared with some jokes, local news, interesting articles, family updates, and personal stories. Dementia can make communicating with loved ones difficult, but conversation nourishes relationships and strengthens connections, enhancing both physical and mental health.

 

For further reading:

Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides. (2015) Sprangers, Dijkstra and Romijn-Luijten

I Care. A Handbook for Care Partners of People with Dementia. (2014) Brush and Mills