How to Talk to a Loved One Who Has Dementia: Never Say 'No' - CNET

This communicative is portion of Mysteries of the Brain, CNET's heavy dive into the quality brain's infinite complexities.

I'll ne'er hide the past existent speech I had with my precocious mother-in-law, Grace. She'd had Alzheimer's illness for a fig of years, and making a telephone connected her smartphone was getting pugnacious for her. So I was amazed to spot her sanction popular up connected my screen, calling maine connected a random Thursday nighttime successful the autumn of 2021.

The author's mother-in-law, Grace Peters, connected her 84th day successful 2020. She died conscionable a fewer weeks aft turning 85, successful 2021, and spent her past twelvemonth battling Alzheimer's.

Mike Valenziano

"Are you watching 60 Minutes?" she asked.

I paused. I hadn't watched the news-magazine amusement successful decades, but I knew it aired connected Sunday nights, not Thursdays. I besides knew however confused Alzheimer's had made my mother-in-law. 

Before her illness, she'd ever kept up with the quality and had beardown opinions connected authorities -- adjacent campaigning for John F. Kennedy erstwhile helium ran for president successful the 1960s. She kept her caput progressive good into her 80s by doing the regular crossword puzzle successful her favourite newspaper, The Los Angeles Times, and she loved to sermon caller books with me. 

But Alzheimer's had robbed her of her focus, and often her words. I knew however hard that was for her, however she became frustrated to the constituent of tears erstwhile she couldn't marque herself understood. If she thought she was watching 60 Minutes connected a nighttime it wasn't on, I was not astir to disagree with her.

"Yes, I'm watching 60 Minutes!" I said instantly.

It was the close answer. In a happy, satisfied voice, she said, "They're a bully couple, aren't they?"

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Couple? Who was the couple? Mike Wallace and Morley Safer? Weren't they dead? It didn't matter.

"Yes!" I said.

"OK, I'll fto you spell now," she said, and the telephone was over. Grace died astir a period later, astatine property 85. She'd moved from her two-bedroom California condominium into a beauteous assisted-living installation conscionable 8 months earlier, hardly getting a accidental to bask its hairsbreadth salon, tract trips and different amenities. 

Her wellness deteriorated quickly, and she soon needed 24-hour care. We moved her from the infirmary to a board-and-care location tally by a compassionate Russian doctor, and she lived determination for conscionable 1 week earlier passing away.

Every day, I'm thankful I agreed with her during that telephone call. In her world, she was watching a "nice couple" connected 60 Minutes connected a Thursday night, and I knew capable astir her dementia to effort to participate the satellite she inhabited. 

'I've got your back'

Diana Waugh knows conscionable however hard it tin beryllium to talk to idiosyncratic with cognitive loss, whether it's Alzheimer's disease, Lewy assemblage dementia oregon different condition. Waugh is simply a seasoned caregiver and a certified dementia practitioner. Her business, Waugh Consulting, focuses connected giving caregivers and household members the tools to pass with loved ones suffering from dementia.

But Waugh didn't ever cognize however to bash this. Her ain mother, Iona Kiser, suffered from dementia and died successful 2008 astatine 95.

Diana Waugh is shown present with her mother, Iona Kiser. Waugh whitethorn beryllium an adept connected moving with radical who person dementia now, but erstwhile her ain parent was aging, she says "I did everything wrong."

Diana Waugh

"I did everything wrong," Waugh says. "I was little than palmy with her."

Since then, Waugh has published a abbreviated book, I Was Thinking: Unlocking the Door to Successful Conversations with Loved Ones With Cognitive Loss. She's spoken to countless caregivers, and produced galore videos explaining her approach. 

Waugh says she tin sum up her doctrine astir conversations with them successful 1 phrase: "I've got your back." She besides holds beardown feelings astir the connection "no" -- saying caregivers shouldn't usage it. And she encourages caregivers to divert perchance troubling conversations to absorption connected aged memories their loved 1 tin easy discuss, arsenic opposed to trying to quiz them connected caller accusation their brains conscionable can't access.

Her enactment won't springiness her that clip with her ma back, but she's helped galore different radical on the way.

Sheila Qualls' 86-year-old parent has dementia, and Qualls has been moving with Waugh connected however to amended pass with her mom.

"I miss my mom, but Diana taught maine however to 'access' her," Qualls says. "Her techniques person made a immense quality successful however we respond to my parent and person changed our lives."

Short-term-memory drawer has nary bottommost

Waugh explains that your loved one's representation has 2 "file drawers" -- short-term and semipermanent memory. The items successful semipermanent representation are mostly inactive accessible. But the record drawer that should cod short-term memories has nary bottom. The memories simply can't enactment put.

"So if you inquire [a idiosyncratic with representation loss] to spell to luncheon with you tomorrow, they enactment that successful the short-term drawer [and it's forgotten]," Waugh says. "You amusement up, they're inactive successful pajamas. A astute idiosyncratic says, 'Let's spell anyway.'"

The idiosyncratic with dementia can't archer you however they consciousness today, Waugh explains, since that involves short-term memory. But they tin archer you "how it felt erstwhile they wounded their genu astatine property 40."

Tap into semipermanent representation

That's precisely wherefore Waugh encourages caregivers to pat into their loved one's semipermanent representation whenever possible. Her slim publication has a fig of workbook pages wherever she encourages radical to constitute down memories they tin bring up with their loved one. What did they similar to taste? To perceive to? To touch? 

Always person 3 stories astatine the ready, Waugh tells clients, and past usage them to support the impacted loved 1 successful the conversation. Bring up those aged memories and promote them to speech astir those things. 

Qualls says this maneuver works.

"My ma whitethorn not retrieve who I am, but erstwhile I statesman talking astir her puerility oregon my puerility experiences, she tin prosecute close away," she says.

It tin besides beryllium adjuvant to amusement photos to your loved one, but "make definite they're aged photos," Waugh warns. A caller great-great-granddaughter whitethorn beryllium cute, but it's improbable a idiosyncratic with cognitive nonaccomplishment volition person immoderate thought who that babe is.

Divert and redirect

Waugh tells a communicative of a pistillate who moved her aged begetter from Nashville to Houston and disquieted he'd privation to instrumentality to his acquainted barn, which was present respective states away.

In specified a scenario, alternatively of telling him no, that his beloved barn wis gone, Waugh says caregivers should calmly usage the barn arsenic a jumping-off spot to get the antheral talking.

"Say, 'I was reasoning astir that 1 racehorse you had," Waugh says. "And erstwhile they commencement [talking], fto them go."

Qualls recovered this method invaluable arsenic well.

"Diana besides taught maine however to reply questions erstwhile my parent wonders wherever my begetter is," Qualls said. "Divert and redirect. Works similar a charm. Diana taught maine to participate my mom's satellite alternatively of trying to bring her into my reality."

Taking distant the car keys

Many radical archetypal tune successful to cognitive nonaccomplishment erstwhile they recognize their loved 1 tin nary longer thrust safely. But however to get them to springiness up the keys? You mightiness beryllium tempted to prevarication and accidental their car is broken. 

Alzheimer's illness moved quickly. Grace Peters is seen present with her granddaughter, Kelly Cooper, successful 2016, earlier she began to endure representation loss.

Gael Fashingbauer Cooper/CNET

That doesn't work, Waugh says. If the loved 1 is aboriginal connected successful their cognitive loss, "they'll telephone AAA to get that 'broken' car fixed."  

Instead, she suggests telling them astir a scary incidental you precocious experienced connected the roads, oregon assertion you precocious got mislaid portion driving. These kinds of stories mightiness deed location with idiosyncratic who's astir surely opening to announcement problems. You mightiness besides beryllium capable to person them a household subordinate needs to usage their car for a while, conscionable to person an excuse for wherefore it's abruptly inaccessible.

Here's what to ne'er accidental

Waugh encourages caregivers to debar 1 word: no.

"'No' doesn't bash a darn spot of good," she says, explaining that the connection lone angers the loved one. If you tin divert the speech instead, the idiosyncratic volition apt hide the diversion successful 5 minutes and happily determination on. But if you marque them huffy by telling them "no," they'll beryllium huffy for the remainder of the day, she says.

Waugh understands wherefore frustrated caregivers mightiness beryllium tempted to accidental no. Their loved 1 mightiness beryllium insisting they request to get to enactment erstwhile they haven't held a occupation successful years.

By saying "no," the caregiver is hoping, she says, to bring the idiosyncratic backmost to world by denying their "erroneous thinking." But the idiosyncratic they emotion is surviving successful their ain reality, and the caregiver volition request to support saying "no" implicit and implicit again, expanding accent connected the relationship.

Avoiding "no" makes sense, but Waugh besides says caregivers shouldn't say, "Do you remember?" What whitethorn look a gentle punctual tin beryllium seen arsenic a demanding quiz to idiosyncratic losing their memory.

"It's similar waving a reddish emblem successful beforehand of a bull," Waugh says. "The idiosyncratic apt does not retrieve immoderate it is, and asking them to bash truthful puts them nether unit they nary longer cognize however to handle."

What to accidental alternatively

Instead, Waugh encourages radical to usage a operation from the rubric of her book, "I was thinking…" arsenic a starter to promote memories. If a loved 1 tells you they person to get to work, though they haven't had a occupation successful years, calmly say, "I was thinking…" and past motorboat into immoderate item astir a occupation they erstwhile had. 

If it abruptly occurs to them they've mislaid a loved 1 -- adjacent if that happened years ago, you mightiness commencement disconnected with "I was thinking…" and past subordinate a blessed representation astir that loved one's pie-baking skills.

Successfully communicating with loved ones who person dementia tin beryllium wrenchingly hard. Waugh knows that lone excessively well. 

"We request to halt looking astatine [our loved ones] arsenic we ever have," Waugh writes successful her book. "When we alteration our expectations, we tin find them arsenic they are. We tin person meaningful conversations. Our relationship, though different, volition beryllium truthful overmuch much fulfilling. It volition supply america with blessed memories of the second portion of their lives."