We have previously given short lists of do's and don'ts for people trying to communicate with those suffering from Alzheimer's disease; these were principally aimed at family friends and visitors who are relatively inexperienced in meeting Alzheimer's subjects. This 30-minute video from Healing Arts Communications, called "How to Communicate With Someone Who Has Alzheimer's Disease or Related Dementia" is aimed more directly at close family members and caregivers.

The video is written and directed by Marion Karpinski, RN. It consists of a number of experts talking directly to the viewer about many of the problems that caregivers face on a daily basis. The style is not didactic, but a lot can be learned, in spite of an absence of clear structure. The viewer feels directly spoken to, in an expert but non-condescending way.

Several of the common difficulties caregivers encounter are explained in a way that should certainly lead to improved communication. It is emphasized that the Alzheimer victim's feelings persist long after recent memory has gone, and these feelings must be respected.

Alzheimer's subjects will often give the wrong answer to a question, not because they are lying, but because they can't comprehend the question or remember what the right answer should be. Loss of their ability to find the right word leads to increasingly vague responses, and there's really no advantage gained by correcting or arguing with the patient.

Repetitive questioning is another common problem that's well handled in the video. The patient obviously has some concern that sets off these questions, and the best solution is for the caregiver to provide an answer that will relieve the concern. The answer must be repeated as often as necessary. Aggressive behavior is part of a similar pattern. Subjects become aggressive when they are being frustrated in some way, so the best response is try to identify this frustration, and relieve it, as far as possible.

Often more can be achieved with signs, gestures and body language, rather than words. Distractions, such as singing, may be helpful. Since loss of word power is such a feature of Alzheimer's, tone, posture and context of the caregiver are often better understood than the spoken word. Social cues, such as sitting down together, can be effective.

A frequent question that's difficult to handle is something like "where's Jane?", when Jane has been dead a number of years. There's no point in the trying to explain this to someone whose sense of time has gone. It's better to say "she's not here right now, tell me about her", and lead the subject into other reminiscences.

A common theme that emerges from the video is the need for caregivers to "go with the flow" as far as possible. This may mean changing daily routines, being as flexible as the situation demands, and mild subterfuges such as changing the subject or being deliberately evasive.

Caregivers often wonder why they should try to communicate at all with someone who seems to be incapable of understanding them. The answer, illustrated by an excellent example, is totally convincing. Trying to communicate with Alzheimer's patients is a worthwhile task. Videos such as this one can only help in making that task easier and more meaningful for both sides.