Compassionate Communication

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 for granted that they understand what you said or that you understand what they meant.
• Don't take it personally.

Do

• Give short, one-sentence explanations.
• Repeat instructions or sentences exactly the same way.
• Allow plenty of time for comprehension.
• Eliminate "but" from your vocabulary; substitute "nevertheless."
• Agree with them or distract them to a different subject or activity.
• Accept the blame when something's wrong (even if it's fantasy).
• Leave the room, if necessary, to avoid confrontations.
• Respond to the feelings rather than the words.
• Be patient and cheerful and reassuring.
• Do go with the flow.

Please elevate your level of generosity and graciousness.

Remember

They are not crazy or lazy. They are saying normal things, and doing normal things, for someone with a degenerating brain. If they were doing things, or saying things, to deliberately aggravate you, they would have a different diagnosis.

Some days they'll seem normal, but they're not. Their reality is now different than yours and you cannot change them. You can't control the disease. You can only control your reaction to it.

Their disability is loss of mental abilities, memory and motor functions. They cannot remember and can't remember that they cannot remember. They may ask the same question over and over, believing it's the first time they've asked.

They do not hide things; they protect things by putting them in a safe place. Do not take "stealing" accusations personally.

They are scared all the time . Patients react differently to fear. Some 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 you everywhere).

Examples For Communicating

DON'T REASON

Patient: "What doctor's appointment? There's nothing wrong with me."

Don't (reason):
"You have 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."

Do (accept blame):
"I'm sorry if I forgot to tell you."

DO REPEAT EXACTLY

Patient: "I'm going to the store for a paper."

Don't (repeat differently):
"Please put your shoes on... You'll need to put your shoes on."

Do (repeat exactly):
"Please put your shoes on... Please put your shoes on."

DON'T ASK QUESTIONS OF RECENT MEMORY

Patient: "Hello, Susie, 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 REMIND THEM THEY'RE FORGETTING

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?"

Do: (distract)
"Let's call him when we get back from our walk."

DON'T ARGUE

Patient: "I didn't write this check for $500. Someone at the bank is forging my signature.

Don't : (reason)
"What? Don't be silly! The bank wouldn't be forging your signature."

Do: (respond to feelings)
"That's a scary thought."

Do: (reassure)
"I'll make sure they don't do that." Do: (distract) "Would you help me fold the towels?"

DON'T TAKE IT PERSONALLY

Patient: "You're not taking good care of me! You're trying to kill me!"

Don't (take it personal)
"I'm not trying to kill you! You've just gotten so mean and hateful!"

Do: (understand)
She/he may be afraid of being alone or of dying. She may not remember where you are when you're not in the room.

Do: (control your reaction-see the feelings of the patient, not the words)
Spoken softly, "I love you and I will take care of you and be here for you."

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."

Do: (distract)
"How about some milk and cookies? Would you like chocolate chip or oatmeal?"

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."

Do: (reassure)
"I love you and we're going to get through this together."

Do: (distract)
"You know what? Don has a new job. He's really excited about it."

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."

"Once Dementia is diagnosed, the patient is excused 100% of the time."

PLEASE CONTACT

The Alzheimer's Resource Center
2246 Montgomery Highway, Suite 1
Post Office Box 1170
Dothan, Alabama 36302
(334) 702-2273
(888) 702-8689

This information is being furnished to you by:

The Southern Alabama Regional Council on Aging (SARCOA) which is the Area Agency on Aging for Southeast Alabama including Barbour, Coffee, Covington, Dale, Geneva, Henry and Houston counties.

Location:
230 North Oates Street
Dothan, Alabama 36301

Mailing Address:
Post Office Drawer 1886
Dothan, Alabama 36302

Telephone:
(334) 793-6843 or Toll Free 1-800-239-3507

Fax:
(334) 671-3651