Caregiving Strategies Following a Downward Turn

Mom has lost ground the past six months. If two people carry on a conversation within her hearing, she becomes upset because she can't keep up with the rapid give and take flow of meaning.  "I can't hear a word you two are saying," she'll say. I don't believe the difficulty is her hearing, I think she's having trouble processing quickly enough to comprehend meaning.  SO--I need to provide one on one conversations, speak slowly, and ask questions. Mom loves to be the center of attention, and if I will ask general questions that don't put her on the spot, she shines. She can expound for a long time using her own sometimes creative thoughts as a springboard for conversation.

She can no longer follow dialogue on TV.  We tried an episode of Little House on the Prairie today and she became very frustrated.  "They are just spouting gobbldygook!" she said.  "They are trying to drive me crazy!"  SO--I need to collect more children's films that have very little dialogue.  She loves Bambi because the animation is adorable and the film has only about 1000 words of dialogue.  I have a video of narrated Beatrix Potter tales that I think she will enjoy; the pace is gentle, and the camera moves slowly over stills of Potter's original illustrations.  As a former teacher I've noted that newer children's books often have more frenetic color and dialogue than those from years ago, and so I've ordered Mom these videos of narrated children's books from years past:  Make Way for Ducklings and More Delightful Duck Stories, and Caldecott Favorites featuring The Snowy Day. (If Mom doesn't like them, the grandkids will--and if they don't I will!) 

Mom used to enjoy a wide variety of music from classical to jazz.  But recently jazz music depresses her.  Perhaps it brings memories of lost youth, but each time I've played a c.d. of the jazz selections she used to enjoy, she has been brought almost to tears. "I just wish I still had a husband," she said.

SO--today I selected a TV channel that plays classical music, but this disturbed her as well.  "This is too much, too fast," she said.  So I put the same ol' five c.d.'s into her player that we've found through long trial and error to be pleasing and calming for her--two gospel c.d.'s, a quiet piano selection, and two c.d.'s by the Bill Gaither trio. "That's better!" she said.

Each time Mom has a downward turn I find I have to transition again through stages of grieving.  We've been struggling the past few months as I've experienced those old, familiar emotions of anger and betrayal, and I have had trouble not expressing those feelings in interactions with Mom.  Her increasing confusion has caused her to feel angry, and that sure doesn't help.  But I'm finally emerging from this latest sad time into acceptance, and am gearing up to meet this latest set of caregiving challenges.

SO, for a late mid-stage Alzheimer patient try these strategies:

--choose films & TV that move at a moderate to slow pace with engaging images and as little dialogue as possible
--try children's books with beautiful pictures on cd to read along or dvd to watch, look for gently paced dialogue
--speak slowly and directly to the person, don't talk over his/her head to another person in the room
--ask general questions that don't put the patient on the spot, and be tolerant of creative/imaginative stories
--remind yourself that the person's behavior isn't personal, it's the disease process, and that the Lord is with you both.
--and remember...love is patient, love is kind...

With prayers for my fellow caregivers, and appreciating your prayers for us,
Linda