In any relationship, developing empathy—the capacity to understand and accept what the other person is experiencing—helps to engender a sense of connection and trust. Entering into the other’s perspective enhances communication and fosters effective relationships. This is particularly true in dealing with Alzheimer’s patients. Suffering from irreversible brain damage, they can no longer adjust their behavior to the external environment, including the needs and desires of the people in their lives. Rather, it is we who must adapt our behavior and their environment to the new reality being experienced by Alzheimer’s patients.

A basic understanding of the nature of dementia and the following communication tips can help you to reach the essential person behind the memory loss. This approach makes the most of what remains—emotional functioning—while minimizing expectations for interaction on the cognitive level.

What helps?

- Approach the Alzheimer’s patient from the front, conveying warmth and acceptance via eye contact, smiles and relaxed body language. Remember, you are the one to set the mood!

- Identify who you are (repeatedly, if needed). Speak slowly, clearly, in short sentences. Use a calm and gentle voice. Give one direction at a time. Offering sincere compliments goes a long way toward engendering positive feelings.

- Treat the person with dignity and respect. Be patient. Don’t rush the person. Focus on feelings rather than facts.

- Engage the Alzheimer’s patient in conversation that centers on the present moment (e.g., “Would you like a drink?; “It’s sunny today.”) This focuses on functioning immediate memory. Or you can help persons to access long term memory by encouraging reminiscence about younger years. Encourage the person to elaborate on your specific statements rather than ask general questions (e.g., “You worked for the railroad, didn’t you?”, rather than, “What did you do for work?”).

- If the patient engages in problematic behavior, remain calm, validate his or her feelings and offer helpful alternatives. For example, if someone is calling for his or her deceased mother, you might say, “I can tell you love your mother very much. Tell me about her.” Or you might say, “Sometimes I feel lonely and want my mother, too. I’d be happy to sit with you awhile.”

- If a person repeats the same question over and over, it does not harm. Respond with as much patience and presence as you can. Remember, the process of connecting and reinforcing positive emotions is the goal, not the content of a stimulating “meeting of the minds”.

- If you upset someone, simply say, “I’m sorry” and try something else. Each moment is brand new!

What does not help?

- Trying to teach Alzheimer’s patients new strategies to deal with their decline (e.g., micro-waving frozen dinners when no longer able to cook). The illness has robbed them of their capacity to learn.

- Playing “Twenty Questions” in an attempt to jar memory (e.g., “Do you know who I am?’ “What did you have for lunch?”). Emotionally, the person will feel the shame of being unable to answer correctly.

- Attempting to argue/reason with the Alzheimer’s patient. It will not be a successful strategy and you both will be saddled with feelings of frustration.


Ministering to Persons with Alzheimer’s Disease and Related Disorders Copyright © December 2000 Office of Health Care Ministry, Archdiocese of Bos-ton. Used with permission. All rights reserved.