Nov 19, 2013

Alzheimer's Communication and the Holiday Season

Communicating with the deeply forgetful is not only about memory, it is about feelings. It is not about words. It is about connection.

By Bob DeMarco
+Alzheimer's Reading Room 

Alzheimer's Communication and the Holiday's

We are now entering the Holiday season - Thanksgiving, Christmas, Hanukkah, etc.

This can sometimes be an anxiety ridden season for Alzheimer's caregivers and the deeply forgetful.

How do you cope and communicate with a person living with dementia during the Holiday season?

It is not unusual for me to get asked, how do you communicate with a person living with Alzheimer's?

I concluded some time ago that during the Holiday period its best to focus on feelings.

Typically, Alzheimer's patients can't remember the right now. So they they might ask, where are we going, why are we here, why are all these people here?

Or worse, I want to go home, can we go home, why don't we go home, why can't we go home?

When this starts happening it brings to the caregiver or family or relatives a feeling of confusion and sadness. Sometimes frustration or anger.

Those are your feelings. But what about the person living with dementia, how are they feeling?

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The key word here is - feelings.

I learned that when a person living with dementia asks these difficult questions it is better to use less words, basically to focus on using nonverbal communications.

It really does not work well if you try to explain.

Trying to explain - why - usually leads to an excessive number of words. The more words you use the more confused the deeply forgetful become. If they can't remember what day it is, what month, or what season, why would you assume they can remember and absorb a complex explanation?

During the Holiday's your number one tool is the smile.


How do you feel when someone smiles at you?

Normally, it makes you feel happy.

Take an inventory when someone smiles at you? How do you feel? I think you will find that you get a warm and fuzzy feeling that travels from your brain and into your body. A smile causes a kind of comprehensive feeling that traverses our entire body. We feel good, happy. Warm inside.

With Alzheimer's and dementia the main problem resides within the region of the brain called the hippocampus. The hippocampus takes in information and then stores it in the appropriate part of the brain. When the hippocampus is not functioning, new information does not get stored.

More or less, new information goes in one ear and out the other. Gone.

However, there are other regions of the brain that are not related to remembering and are related to feelings. Feeling happens in a different region of the brain.

Alzheimer's patients might not be able to remember the short term, or the new stuff, but they can still feel.

During the Holidays, before you speak, you should always smile. And, you should wait patiently until you receive a smile back. This is an effective, very powerful, form of nonverbal communication.


It will also help if before you smile, you first make contact. For example, by taking the hand of a person that is deeply forgetful. Touching is a very powerful form of nonverbal communication.


Touch can be comforting. It is also a signal that I care about you.

The combination of smile and touch can be used

to traverse the bridge that often separates the deeply forgetful from others.

You can traverse the bridge and make communication contact without saying a single word.

You are now in Alzheimer's World.

When you traverse the bridge and step foot into Alzheimer's World your brain will take over. You will likely feel a sense of compassion and understanding. You will feel calmer. Alzheimer's World is a kind and gentle place.

The kinds of communications I am suggesting are not about memory - they are about feelings. It is not about words. 

It is about connection.

If a dementia patient is confused or wants to go home the first thing you must do is reconnect with them.

Shut your mouth, traverse the bridge first. 

 Communicate silently with your hand (touch) and your mouth (smile).

One last word of advice.

The deeply forgetful can't remember the right now. However, they can remember the past.

Their brains are full of memories. 

Memories that were stored away in the brain long before the hippocampus stopped functioning properly.

I noticed the best place to discuss and bring out memories is at the kitchen table. This is a place where we talk. Tell stories.

So consider this to to get your Alzheimer's patient anchored.

Sit them down at the kitchen table and have family and friends talk about the old times, the old days.  The good times.

If you are lucky the person who is deeply forgetful will tell you a wild and crazy story that is loosely based on fact. They will weave together a tale that can be both fascinating and mesmerizing.

The deeply forgetful can turn into story tellers if you guide them to the past. 

Amazingly, these stories can be even better and more believable than the fact based story by itself.

Listen closely. You will figure out how each part is coming from a part of their slightly fractured brain.

They just patch the stories together.

Smile. Touch. Traverse the bridge.

Turn Burden into Joy.

Use your fully functioning brain to accomplish this Mission.

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+Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized expert, writer, speaker, and influencer in the Alzheimer's and Dementia Community worldwide. The ARR Knowledge Base contains more than 4,000 articles. Bob lives in Delray Beach, FL.
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