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Thursday, September 13, 2012

Connectedness and Attachment in Alzheimer's Care


Ever feel disconnected or detached from a person living with dementia? Disconnected from the deeply forgetful? Yes, I bet you do. So did I.

By Bob DeMarco
Alzheimer's Reading Room


Connectedness and Attachment in Alzheimer's Care
One thing that disturbs me, disturbs me every time, is when I read in the comments section below articles that someone else's Alzheimer's patient is not like mine.

Generally this revolves around the idea that their Alzheimer's patient is mean; and as a result, what I suggest won't work for them.

Did you know that Dotty was meaner than a junkyard doberman pinscher when I first moved to Delray Beach to take care of her?

Dotty changed. She became sweeter than a Krispy Kreme donut. Many of you saw her and heard her right here on the Alzheimer's Reading Room in the videos and podcasts. Want to see Dotty in YouTube go here, look for the videos with her image on the start page.

Well, if my junkyard dog became sweeter than sugar why can't yours?

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Lets focus in on one simple example.

My junkyard dog would yell at me and say get out. "Get out, I don't need you, I can take care of myself."

When put in context this was particularly hurtful. I was taking care of my mother full time, essentially giving up my "other" life to take care of her. And then, I had to listen to her tell me to "get out" over and over.

I did what most caregiver do at the beginning. I responded by telling her she couldn't live without me. Without me, it was the dreaded "home".

Of course this only made the conversation more heated, more hurtful, and more disconcerting for both of us.

Once I realized this wasn't working I decided to take a new approach, I kept my mouth shut when she said something mean.

No, this didn't work.

Finally, thank goodness, I concluded that something had to change. I had to change.

As part of my change I started to listen to what Dotty said and examine what she really meant by her words.

Did she really want me to "get out"? Well that just didn't make sense. She never said it before AD.

What was Dotty saying?

Dotty was trying to tell me she was scared to death and was constantly worried that she was going to be put in the dreaded home. Yep.

Communication in Alzheimer's World is often very different than in the real world.  Many times the communication is upside down and backwards, so to speak.

So instead of reacting harshly or ignoring Dotty, I started listening too and examining her words. Soon I was able to read between the lines. Soon I came to the realization that Dotty was feeling insecure, scared, and often confused. This is what happens when you become deeply forgetful.

When you become deeply forgetful your ability to think, concentrate, learn, and remember is negatively affected.

I learned two things. One, words don't work very well. Why? Because the deeply forgetful can't remember the right now, what just happened, and what was just said very well. It just doesn't sink in.

Two, I learned that that best way to deal with challenging behavior and mean spirited words was to do exactly the opposite of what I would have done in real world.

This led me to the mirror approach to Alzheimer's caregiving.

Instead of reacting harshly to what Dotty said, or just ignoring her, I decided I would instead do the exact opposite of what she was doing. The mirror approached. When you look in the mirror everything is the opposite.

So when Dotty would say "get out", I would go over put my arm around her shoulders, put my head on her head, and say, "I'm not going anywhere". Sometimes I would add, we are here together now; or, I am here to watch over you and take care of you.

It took a while but Dotty stopped telling me to get out. Obviously, we started to get along better. And better.

It became obvious over time that words didn't work well. What does work well is nonverbal communication.

When I would walk by Dotty and before I came up on her, I would stick my hand out. Sure enough she started sticking her hand out. I would rub my hand across her hand. It felt nice. Dotty started smiling.

I did come up with a better way over time. Instead of rubbing hands, I would attach the tips of my figures, the pads, to the tips of her fingers.

My goodness. It is amazing how wonderful this feels. You really get a sense of connectedness and attachment.

Connectedness and Attachment

Ever feel disconnected or detached from a person living with dementia? Disconnected from the deeply forgetful? Yes, I bet you do. So did I.

So did I.

This is a 93 percent solution. If you start putting your arm around and putting your head against a person who is deeply forgetful you will start on the path of connectedness.

If you start touching the finger pads, start rubbing cheeks together, and developing a nonverbal pattern of touch and communication you will get on the path of connectedness.

The path of connectedness leads to a strong attachment.

Once attached you will leave the burden behind and start traveling the path of Joy.

It is okay with me if you want to tell me this won't work for you. And, it is okay with me if you don't want to try.

Know this. I did it. I know many others that did it. And you have a 93 percent chance of success.

You decide.



Bob DeMarco
Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The ARR knowledge base contains more than 3,811 articles with more than 298,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room