Never Say Never: New Year's Resolutions for Caregivers

Author: Brenda S. Parris
Published on: Jan 26, 2003

By this late in January many of us have already broken some if not all of our New Year's Resolutions. Someone brings a tempting dessert to share in the lounge at work, and it looks too good to resist, in spite of our New Year’s resolution about dieting. And it is just too cold outside to continue our walking/exercising when we could be warm and cozy inside with a cup of coffee and a book or the Internet to surf. But it's never to late to try, and for caregivers, each day is a new day to resolve to make life as pleasant as possible for the person with Alzheimer's.

In thinking of what New Year's resolutions a caregiver might make, I found a wonderful list in the form of a flash-card entitled "The Ten Absolutes of Caregiving for Alzheimer's Patients", located on Dr. Robert Stall's Web site. These were taken from a seminar done by Jo Huey of the Greater New Orleans Patient and Family service Committee and reprinted in the Western New York Alzheimer's Association Chapter's Newsletter.

1. Never argue, instead, agree
2. Never reason, instead, divert
3. Never shame, instead, distract
4. Never lecture, instead, reassure
5. Never say remember, instead, reminisce
6. Never say "I told you", instead, repeat
7. Never say "You can't", instead, "Do what you can"
8. Never command, instead, ask or model
9. Never condescend, instead, encourage and praise
10. Never force, instead, reinforce

I cannot think of a better set of resolutions for getting along with an Alzheimer's patient, and making each day more pleasant for both patient and caregiver. These are not always so easy to accomplish, but the difference they make is certainly worth the effort. Caregivers must remember that in the confusion that Alzheimer's brings, especially in the stages where the patient has delusions and hallucinations, arguing or trying to correct the patient only brings agitation, increases catastrophic reactions, and just makes life harder for everyone involved. The natural response of a caregiver may be to try to correct the person, to tell them their delusions or hallucinations are not real, in an effort to calm them, but the effect upon the patient is often negative. They will not be convinced that what they have seen in a hallucination or a dream they just had is not really happening. The caregiver must learn to agree, and then to divert their attention, distracting them from what is upsetting them, and being as reassuring as possible.

In the earlier stages when the patient is repeating and questioning again and again, the caregiver has to learn to act as if each time is the first time to hear the statement or question. Patiently acknowledging the statement or answering the questions is all that is needed. No "I told you before" or "you've already told me that" reactions are necessary, and avoiding them may prevent agitation in the Alzheimer’s patient.

The caregiver has to learn that the Alzheimer's patient cannot be forced. In one seminar I attended, the speaker said to "choose your battles". Most things caregivers feel they have to get the patient to do are not really all that necessary. The patient does not have to have a bath every single day. He does not absolutely have to take all of his vitamins each day,. If he does not want to eat a meal, the patient should not be forced to. If only one of these things can be accomplished each day, that is fine. There may be some days when none can, and that is also ok. There are nutritional supplemental shakes and snacks that may be given between meals, so that the patient will not be under nourished.

Caregivers have days when they fail at these ten absolutes and make mistakes that they regret, but each new day is a chance to start fresh, to resolve again to make life better in spite of Alzheimer's. It is never too late until the patient is gone. I made many mistakes as my mother's caregiver, but I learned from them, and I invite you to learn from them as well and perhaps avoid similar mistakes in your own caregiving experience. My book, Waiting for the Morning, and my Web site, A Year to Remember tell our story, and I hope they will help you to resolve to make each day a better one in your journey with Alzheimer’s.