Creating Too Much Demand

Many caregivers feel they need to exercise the patient's brain, testing every day and pushing them to achieve. In addition, it is unnerving for family members to hear the patient make mistakes and not correct them, but it is essential.

Think about how you feel when someone tells you you've made a mistake. Being corrected feels pretty bad. The patient with memory loss is constantly confronted with their mistakes, which is pretty uncomfortable.

What we try to do is make the patient feel comfortable with the knowledge they have -- as long as they are safe First, don't try to exercise the brain. The brain is not a muscle. People with memory loss are not lazy, they have a disability that is, in many ways, like an amputation.

We have to assume they are working as hard as they can at any given moment with the abilities they have left at that time. People with memory loss have good days and bad days. Accept the patient's changing abilities each day -- or hour-- as the best the person can do right now. Avoid quizzing the person: "Do you remember me?" "What is her name?" "Remember what we did yesterday?" Life becomes like a constant test for people with memory loss and we don't want them to feel as if they have failed that test again and again.

If the person becomes upset, try to distract them rather than confronting. If that does not work and the person is safe, walk away and let them forget Do not announce things in advance. People with memory loss have problems figuring out time. They become upset and fearful about schedules -- especially doctor visits.

Announce activities at the last possible moment. Let the patient forget. If you lose your temper, the patient refuses to bathe, or there is a behavioral outburst, leave the patient alone and approach them again later. The outburst will probably have been forgotten If the patient has forgotten how to do an activity, help them with it.

Don't try to "talk them through it," or have them "think about it." Thinking about it only worsens the problem. Use distraction instead. Distraction is simply changing the subject. Examples include: moving on to another task; giving the person a glass of juice or water; making a phone call to a friend; looking at family pictures in an album; or reading a letter aloud. Let the memory loss work for you. If a letter, joke, or other distracter is helpful once, don't be afraid to use it again and again. Sometimes your loved one's forgetting can actually be useful. If they become upset about something, reassure them and don't bring it up again.

Whenever possible give the person a choice. "Do you want a bath or a shower?" "Would you like a person to stay with you in the home or to enroll in an adult day program?" Realize that we avoid the term "Do you want to..?" The person with memory loss will tend to answer "No!"

Supported by: Iowa Scottish Rite Masonic Foundation,
National Caregiving Training Project,
University of Iowa College of Nursing,
Gerontology Nursing Intervention Center
Research Development and intervention Core

Developed by: Geri R. Hall, Ph.D., ARNP, CNS
Gerontology Clinical Nurse Specialist
Mayo Clinic Scottsdale
13400 E. Shea Boulvard
Scottsdale, Arizona 85259
Phone: 602-301-8111

Alzheimer's Outreach: http://alzheimer'

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