Emerson – Alzheimer’s Association
Smith - Author/Resource literature on age-related
disease and healthy aging
Sally Smith: Welcome to Age
to Age. I’m Sally Smith. Let’s talk.
We’re very fortunate, today, to have with us, again, Fran Emerson, in
charge of the Alzheimer’s Association in our area, as well as the surrounding
area. She is a veritable fountain of
information on caregiving, Alzheimer’s, and positive attitudes and techniques
in dealing with people with dementia.
Fran, one of the things I love is what you wrote to help people deal
with Alzheimer’s. We’ve discussed some
of this previously. But, one of them was
ten absolutes: never do such-and-such,
always, instead do such- and-such. I’m
going to ask you to read these and then we’ll discuss some of them, because I
think they’re very powerful for anybody dealing with Alzheimer’s.
Fran Emerson: Okay,
Sally. Well, it’s great to be here
again. The ten absolutes are very
important when you’re interacting with someone with a dementia.
First, top of the list:
never argue, always agree. Never
try to reason with someone with Alzheimer’s disease, always divert the
conversation. Never shame someone because
they failed in following an instruction, or something like that, but always
distract them. Never lecture; none of us
like that, but reassure. Never say, remember, but, instead, reminisce. Never say, I told you, but just simply repeat.
Never say, you can’t, but just
model what that person may be able to do.
Never command or demand, just ask.
Never be condescending, just encourage people. Never force anyone to do anything, just
reinforce what they’re doing.
I think these are so important when you’re interacting with
someone who is struggling everyday to keep it together.
Sally Smith: Well, I really
feel that is a mantra that should be at every check-in point on every
Alzheimer’s unit. It’s so simple, but we
bring with us our own package, our own life, when we go to work, and it’s hard,
maybe, to switch gears and realize that this is a different person. One thing I’ve heard you say before is that a
behavior always has a meaning, stay calm, know the person, and understand the
disease. Now, know the person, is that like their habits?
Fran Emerson: That’s
right. If you look at it logically, how
can you be a personal caregiver to an individual if you don’t know them? Everybody is so unique, and everybody reacts
in a very different way to any illness they may have. And this is particularly so with a dementing
illness. If you see someone acting in a
way that is challenging, or you can’t connect with, do some homework. You know, what was that person like, what did
they do, what was their job, what was their family background, what was their
Achilles heel when they were growing up?
We’ve all got pet loves and hates, and little things, that make up our
uniqueness. I think knowing the person
is one thing. Understanding Alzheimer’s
disease and what’s happening to the brain is the other. And if you put those two pieces together, you
can develop into a much more powerful and effective caregiver.
Sally Smith: So you’re
really a detective, in a sense?
Fran Emerson: That’s
absolutely it, Sherlock Holmes. Elementary, my dear Watson.
Sally Smith: And,
obviously, you have the patience. That’s
a quality I would like to have a little bit more of. I know, dealing with my own mother, she
couldn’t be rushed. We couldn’t just
figure it out right a way. I mean,
things took time, and I had to get on her
schedule. Do you think that most people
that go into this work are more innately patient, and that’s one of the reasons
they’re successful at it, or is that learned?
Fran Emerson: I think there
are two factors here. I think some
people are more natural caregivers than others, and we talked about that
before. I think that it can be a learned
skill. I think there are some people
that will never even dream of going into the caregiving profession, and will
always find it a struggle if Alzheimer’s happens to strike their family. These people, you know, working in
facilities, and family caregivers at home, have my utmost respect and
admiration, because it takes that degree of patience and commitment. But, you know, the best thing to do is to
understand and accept that this is a disease where you are transformed onto a
different planet, when you become a caregiver.
You’re not in your world, as you say.
You need to step into the world of the person that you’re taking care
Sally Smith: Well, you
know, one thing that I really appreciated on one of your lists is the
therapeutic fibs and hip truths. I find
that quite fascinating, because the part where you say, never argue, I mean,
you’re not going to tell them it’s Autumn, and not Summer. I mean, what’s the point? But, some people might have trouble with bent
truths and therapeutic fibs. Tell us how
they can be your aid in times of trouble.
Fran Emerson: I think it’s
important that whatever someone with Alzheimer’s disease says, however bizarre,
however off-track you know it to be, it’s important to validate that person’s
position, so that if someone in a facility is saying, I have to go home because
the children will be home from school, it’s very easy to react and say, you’re
children are grown up and at work now and you don’t have to go home. You need to enter that situation because that
person is anxious, they want to go home and see their small children; well,
what are their names, tell me about your house, and divert the
conversation. You know, you’re accepting
the fact that someone’s at that moment in time.
So, therapeutic fibbing, I guess it is.
But, what are you going to do, just spend your time arguing with your
loved one, or a client in the facility?
It’s stressful for you and it’s stressful for the person with
Sally Smith: I love that
phrase you used, entering the resident’s world.
And, really, that’s your job, and the best way of giving, of creating,
as you say, a stress-free, happy, peaceful environment. I wish you would close this part out by
telling us, one more time, how you approach a person with Alzheimer’s if
they’re having trouble. I remember you
suggesting that you don’t come up frontally.
I tried to describe that to somebody recently, and I think that bears
Fran Emerson: It’s avoiding
a confrontational encounter with someone with Alzheimer’s. So, coming from the side, if you’re
approaching a person, is important, so that you’re not confrontationally in
front of them, and you’re not creeping up behind them. And, calling them by name, introducing
yourself by name, if they’re seated, getting down to their level, making sure
you’re not towering over someone, making sure that the person doesn’t feel that
you’re in their personal space. That’s a
real important thing. If you’re touching
someone, make that an unsurprising kind of connection, gentle and reassuring. Body language and facial expressions are very
important. People can tell a lot by what
you’re saying through your expressions, body language, long before you open
your mouth. Seventy percent of your
first impressions of someone are actually visual, not verbal.
Fran Emerson: They’ve done
a lot of research on that. And they’ve
done a lot of research on people with dementia who are particularly sensitive
to body language. You know, is this person a friend, or a foe? Is this person going to hurt me, or is this a
Sally Smith: And this goes
back, too, to when we spoke about side issues that can affect things. Some of them may not hear that well, so the
visual becomes even more important.
Fran Emerson: That’s really
important. You know, some people think a
person with Alzheimer’s isn’t responding to them, so they repeat themselves,
and what do they do? They shout more
loudly, which is counterproductive, because people with Alzheimer’s are not
deaf. They just take time
Sally Smith: I see. Oh, Fran, you bring such interesting insights
into this. Thank you so much for being
with us again today. Thanks to all our
listeners too for joining us. We welcome
your suggestions and comments, always.
This is Sally Smith, Age to Age,
saying good-bye and wishing you courage and joy on your journey. We are all connected.
If you enjoy listening to Sally Smith, you
can buy her book, The Circle.
It’s the story of how she personally responded to her mother’s journey
with Alzheimer’s disease. It’s a
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