“Conversation” Talks—But What Does it Say?

“Privy to our deepest thoughts, that kitchen table was a silent listener as Grandma and I had talked late into the night while indulging together in some form of chocolate.” Excerpt from Goodnight, Sweet: A Caregiver’s Long Goodbye, Chapter 7 “Going Home”

Grandma and I, we talked. A lot. Sitting at her kitchen table, on her porch snapping beans or just lounging with our books, we were always chatting about one subject or another. I never ran out of questions, and it seemed she never ran out of great stories. I guess I thought it would be that way forever.

And true enough, it did not just suddenly stop. More like, it was taken away slowly, bit by bit. As Alzheimer’s tightened its grip on Grandma, our conversations underwent a change. The alteration was almost imperceptible at first—a repeated tidbit here, having to remind her of something there, until one day I realized that whenever she was talking, I was pushing my eyebrows together and tilting my head slightly as I was trying to understand her.

Her ability to engage in the kinds of conversations we had always enjoyed was being slowly eroded away by Alzheimer’s—emphasis on the “slowly” part. Nothing with that disease happened quickly. So slight were the early changes that I actually wondered if it was just my imagination running wild.

But I knew Grandma really well, so her muddled conversations truly were one of the first indicators that something was amiss. Even after we had the official diagnosis, adjusting to her inability to engage in basic dialogue was challenging to say the least. Caregivers usually have a hard time accepting these changes, and for my part when I was new at the job, I felt like I did nearly everything wrong!

Arguing the Point

When Grandma informed me in 1995 that Marilyn Monroe had just died, I immediately came back with, “No, Grandma, Marilyn Monroe’s been dead since 1962!” This is one of the worst things we can do with our loved one who has dementia. Arguing with them makes them feel foolish—like they should have known better. They cannot help the gaps in their memory; it’s the nature of the disease.

Instead, try an affirming statement like, “I didn’t know that,” or “Wow, she’ll be missed; I sure enjoy her movies.”

Let’s Take a Quiz

Looking together at familiar photos can be a great way to stimulate conversation with the dementia patient; however, when the caregiver begins to “quiz” their care recipient, things can quickly unravel. The last thing you want to do is start pointing to people in the pics and asking, “Who’s this?” or “You remember her, don’t you?” Quizzing them doesn’t jog their memory, it puts them on the spot and under pressure to recall something that may not be available in their memory any more.

Instead, point to the person in the photo and say, “That looks like Aunt So-and-so,” or “They remind me of Cousin Whoever.” Give the accurate name, and if the person with dementia remembers, then that’s great; but if not, you want to make it OK for them to not remember.

Showing Your Frustration

This is a tough one! Maybe your loved one is sundowning and nothing is calming them down, or they’re repeating a story and you’re worn out with the repetition. I remember Grandma repeatedly telling me that her brother-in-law had died; eventually I could feel the scowl coming over my face, brows knit together, lips pursed as I fought the urge to yell, “Quit telling me the same thing over and over!” The difficulty is the dementia patient doesn’t understand your frustration; to them, it’s news they have, and they want to tell you about it.

Instead, without being too obvious, turn your face away and try to take a breath. As calmly as possible, let them know you appreciate the information. But truthfully, the most important thing caregivers can do to relieve this particular stress is to take frequent breaks. It’s imperative for yourself as well as for the care recipient that you schedule time away from your caregiving duties. Look into the cost of an adult day care program for your loved one, or take advantage of volunteers with your church. Someone may be able to come stay with your loved one for a couple of hours while you go out and enjoy lunch with a friend or just some quiet time away.

Conversation is a bedrock of communication, and as caregivers we want to make the most of this precious tool, but you have to be tactical in your thinking as you deal with the job’s daily requirements to avoid making the common mistakes we’ve discussed here. Education is a great first step—your knowledge of these conversational strategies can help your care recipient live their best life possible, even with dementia.