Maintaining Relationships Impacted by Dementia

Caring for a loved one with a memory disorder can create challenges that may seem insurmountable. People often report frustration, anxiety and even depression, says Alyssa Aguirre, a licensed clinical social worker who specializes in counseling individuals with dementia and their caregivers and serves as the assistant director of dementia care transformation for Dell Medical School’s Department of Neurology.

But it is possible for caregivers to successfully manage their evolving relationship with a loved one with dementia due to Alzheimer’s disease or related disorders. Aguirre and Robin C. Hilsabeck, Ph.D., director of the Comprehensive Memory Center of the Mulva Clinic for the Neurosciences at UT Health Austin, the clinical practice of Dell Med, offer tips.

Tips for Caregivers

Don’t assume; diagnose.

Memory loss is common as one gets older and can result from a number of ailments. Get a diagnosis and support from a knowledgeable medical team. Get the right medications, explore clinical trials and plan for the future.

Accept the new role — and responsibility.

Many caregivers are adult children now assuming a new role in their parents’ lives. Changes can include managing their medications, escorting them to doctor appointments, being there for them more often. It’s important to acknowledge this major shift in the relationship.

Think about the time of day.

Cognitive function can be highest earlier in the day. Choose the right time to plan a visit or an important conversation.

Select conversation topics thoughtfully.

Talk about your loved one’s personal interests and distant memories. Often, events that happened decades ago are easier for those with memory disorders to recall.

Discuss one thing at a time.

Don’t bounce back and forth between different subjects. Avoid, “Come with me, get in the car, we’re going to lunch.” Better: “Let’s go to lunch!”

Touch?

Holding hands, patting someone on the shoulder or giving them a hug can be calming and reassuring — unless it’s not. Watch body language for clues.

Don’t argue.

Don’t think your loved one is being contentious on purpose. Distract them if conversation becomes difficult. Say something like, “You’re upset. I’m sorry.”

Provide simple choices.

Too many options can be confusing. So can open-ended questions like “What do you want for dinner?” Better: “Do you want steak or spaghetti?”

Give time to respond.

Don’t interrupt or answer for someone to speed things along.

Avoid conversation in large gatherings.

People talking in the background can be overwhelming.

Acknowledge what was said.

Even if they didn’t answer your question or steered to another topic, show your loved one you’ve heard them and encourage them to continue.

Pick your battles.

Let go of being right. Avoid criticizing and correcting them. Badgering a loved one who has difficulty reasoning or doesn’t remember does no good. Try this: “Sorry, I must have forgotten to tell you, but let’s go.”

Ask for help.

This can be hard, but it helps you better care for your loved one. Consider asking family, close friends and those who have offered to help to sit with them or phone them. Interacting with more people can stimulate loved ones and increase enjoyment.

Don’t be so hard on yourself.

It’s like learning a new language. It takes practice. You’ll make mistakes, lose your temper. Doing your best is all anyone can expect.

Live in the moment.

Don’t worry if you didn’t do what you planned to do with your loved one. Accept this new reality, new ambiguity, and strive to make each moment worthwhile — even enjoyable.