10 things to remember when you interact with people who forget

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Many of the challenges of interacting with or being a care partner with someone who lives with dementia stem from our own behaviour and expectations.

Memory expert and author Dr. Bill Beckwith suggests 10 key things to keep in mind to help ease the stresses and reduce the anxiety levels of everyone involved:

1) People with dementia (PWD) are not lazy

Rather, many lack the initiative they may once have had. They may become apathetic and less likely to initiate activities or discussion than they previously did. They need environment and social interactions to encourage them to participate in activities and engage with others.

2) Memory loss is not intentional

PWD do not display “motivated forgetting.” They do not remember what they “want to” or “have to.” They do not have “selective memory loss.” They have no control over what they remember and what they forget, which may change from one minute to the next.

3) QTIP (Quit Taking It Personally)

Don’t take comments, anger, or lack of appreciation personally. Despite the fact that those with dementias may reflect your mood back to you or say offensive and hurtful things, they are not acting with deliberation. Besides memory loss, dementia is marked by poor judgment, a decline in the ability to think “logically,” and a tendency not to follow social conventions. Dementia produces a developmental shift to child-like behaviours and reasoning.

4) Inconsistency is the rule

Even as the disease progresses, PWD experience lucid moments as well as flashes of insight, and, while these moments become less frequent and less clear as decline progresses, they may occur until the very end.

5) Don’t challenge delusions or hallucinations

Arguing and/or using logic to counter false beliefs or perceptions (e.g. someone stole my car, there are strangers in the house), is a waste of time and energy. Most delusions and hallucinations are harmless and if not confronted will resolve if approached with compassion and distraction. Confrontation is likely to increase confusion, frustration, agitation; it may trigger anziety and/or aggression and result in PWD being unnecessarily medicated; that’s why it’s so important to never never argue.

6) Don’t try to force memory

Persons with memory loss forget that they forget. Repetition and reminders do not help recall as the disease progresses and the memory becomes more severely impaired. Trying to force recall or asking “Don’t you remember?” may elicit frustration, depression, or agitation. Don’t ask questions, make statements instead.

7) Stick with it!

Interactions with someone who lives with dementia can be uncomfortable. It’s tiring to constantly deal with repetition, lack of initiative, and self-focus. However, PWD need social interactions as much as the rest of us. In fact, they may need us to connect and engage with them more than ever. Don’t abandon those who live with dementia just because it’s the path of least resistance.

8) Be realistic

Don’t hold onto false hope that PWD will improve. Dementia is irreversible and often progressive. Current medications may slow the rate of decline but they do not reverse or stop the deterioration of brain cells. On the other hand, don’t give up on someone who has dementia. Opportunities for growth, healing and beautiful life experiences remain for all of us until we finally die. Take advantage of what skills remain.

9) Don’t compare

Although there are similarities among individuals with dementia, there are a multitude of individual differences as well. Not everyone becomes incontinent, aggressive, unmanageable, subject to sundowning, or forgets who loved ones are. People are unique. People with dementia are also unique – they are still people!

10) Go with the flow

Those with severe memory loss live in the moment – they may not recall the recent past or be able to anticipate what comes next. The environment and people around them must draw them in and simplify their interactions with the world. More about going with the flow here.

Besides these 10 important things to remember, it’s also vital for caregivers not to forget their own needs.

Bill BeckwithDr. Bill Beckwith is a professional psychologist and speaker. He has his MA in experimental psychology and a Ph.D. in clinical psychology; he was a university professor for 12 years. He earned many teaching awards and developed a memory disorders clinic and a center for excellence in memory care. He has completed more than 3,000 memory evaluations, and is the author of Managing Your Memory

 

More great tips here.

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5 Comments

  1. These 10 things to remember are very helpful as I’m just trying to come to terms with my dad and dementia. I admit some days are extremely challenging and I sometimes don’t quite know how to deal with some of dad’s new traits as a result of dementia. I’m only human at the end of the day. When I’m not at my dads I feel guilty and constantly worry about him hurting himself in the house. He’s already fallen down the stairs a few times and we cannot afford a stair lift. So we resorted to coming down the stairs backwards holding the rail of course, so far so good. It’s easy to forget that I have a life too, I have to keep reminding myself. My thoughts are there’s always someone worse off than yourself so I carry on regardless. KEEP YOUR CHIN UP EVERYONE. ALWAYS TREAT OTHERS AS YOU WISH TO BE TREATED and you won’t go wrong! x

    • Darla Sue White on

      Another great article. Most are self explanatory, but not taking it personal was the hardest one for me to learn…I am former abused child, and somehow I felt I deserved all this abuse from my LO in his demented state. It took a long time to realize that he meant nothing harmful toward me. That his frustration & fear was causing him to lash out at the only one he trusted. I learned to just let him get it out of him system & move forward.
      It is difficult to realize that you can nor reason with them because they have zero cognition. Changing the situation works great, distraction, smiles, offering them security, making them feel loved & safe is all any of us want. Dementia sufferers are no different.

      TY Susan for sharing his article…refreshing.
      You are amazing! <3

      • Thanks Darla Sue.

        Yes, it’s hard not to take it personally. I struggled with that too. and eventually learned to get past it like you did. I have a related post on that here: Kate Swaffer and the Q-tip

        You are right there’s no point using logic. I prefer to look at the cognition as “changing” and “different” from mine rather thank “non-existent.” In fact, I think people living with dementia gain a new kind of awareness, a deeper cognition that the rest of us don’t have.

        And yes, I agree with you that we all need to feel loved, safe, and secure. People with dementia are no different in that way from the rest of us, and that’s probably what causes a lot of responsive behaviours in many people with dementia.

        Finally, I changed my perspective on dementia and stopped using the words “sufferers” and “suffering” when I came to understand that those words diminished and lessened people living with Alzheimer’s disease or another form of dementia. Maybe you will consider your use of the word as well. More on that here:

        http://myalzheimersstory.com/wp-content/uploads/2016/02/Alzheimers-Australia-best-language-guidelines-full-1.pdf

        Thanks for your support, and I hope we get to talk one day!

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