Preserving Social Connections When a Loved One Has Alzheimer's
Experts tell us that loneliness threatens the health of older adults. We are a very social species, so when we feel a lack of connection to fellow humans, the resulting stress raises the risk of high blood pressure, sleep disorders, depression, a weakened immune system and a host of other health problems. According to the University of Chicago's Dr. John Cacioppo, the negative effect of social isolation can harm seniors as much as smoking or obesity!
The interplay between loneliness and poor health works both ways, according to a recent study from Concordia University. Lead researcher Meaghan Barlow reported that seniors who are living with chronic illness often suffer psychological distress because their condition curtails their social life. Barlow's team also found that socializing with one's spouse or partner is not enough—it takes a variety of connections to help ill seniors cope.
A diagnosis of Alzheimer's disease or other dementia complicates the situation all the more. Caregivers report that loved ones become isolated and depressed when they can no longer work or take part in familiar activities and other social opportunities. Most distressingly, family caregivers report that even long-time friends and family may back off, not knowing how to relate to the person's "new normal." Author Sarah Leavitt wryly referred to these friends as "casserole droppers"—people who might drop off a meal on the front porch, but not stop in.
Yet it's vital to overcome these challenges in order to support the social needs of people with dementia. Loneliness and boredom increase agitation, depression, sleep disturbances and the other behavioral changes that come with the disease. These behaviors have been described as an expression of unmet needs, and the need for human contact is a particularly strong one! Providing appropriate activities and social opportunities is now considered to be a central pillar of competent dementia care.
Here are 7 tips from dementia care experts and seasoned caregivers:
1. Learn all you can about effective ways to communicate with your loved one as the disease progresses. Most experts recommend that you "meet your loved one where they are." In earlier days, it was considered important to spend a lot of time on "reality orientation"—providing the person with repetitive reminders about the time, the date, the place, the identity of people and so forth. Nowadays, experts believe, it's best to meet the person in their own reality as much as you can, rather than correcting them or continually reminding them of things.
2. Share your insights with guests before visits. Family members and close friends who want to spend time with your loved one might hesitate, feeling uncertain about how to interact with your loved one and uncomfortable about the changes in your loved one’s personality and behavior. Talk to these friends beforehand so they know what circumstances to be prepared for. Your reassurance and guidance can create a more relaxed, enjoyable visit.
3. Encourage visitors to share an activity with your loved one. Conversation can be stressful for people with dementia, making them feel put on the spot. The context of an activity can make for a much more pleasant visit. Provide art supplies or craft materials so your loved one and guest can create a project together. Bring out a simple jigsaw puzzle, or perhaps ingredients to bake a goodie. You might all go for a walk outdoors ... interact with pets ... work in the garden ... go to the park and watch children play ... listen to music and sing. All these activities can feel much more nonjudgmental and relaxed than trying to carry on a conversation.
4. Include your loved one in family events. As much as possible, help your loved one continue to attend family gatherings, holiday celebrations and the like. As the disease progresses, you'll need to take into consideration your loved one's best time of day, tolerance for noise and reaction to changes to their routine. Again, talk to guests ahead of time about your loved one's needs. Small children, especially, benefit from information about why a beloved relative may behave differently. And remind family that sometimes your loved one may be happiest just observing the festivities rather than actively taking part.
5. Take advantage of specialized dementia-friendly activities. Many communities today offer innovative activity programs for people with Alzheimer's, such as "Alzheimer's cafés," where people with dementia and their caregivers can interact in a nonjudgmental environment. Art museums, musical organizations and public libraries have dementia-friendly programs where participants can explore their creativity without fear of stigma. Parks departments offer walking programs, trips to the zoo and intergenerational programs. These special programs bring people with dementia out of their shell and help them express and experience joy.
6. Hire an experienced in-home caregiver. If you are providing care for a loved one with memory loss, you know it can be exhausting trying to manage your loved one's needs while keeping up with your job obligations, your own healthcare and other tasks. A professional caregiver with training and experience in caring for people with dementia can not only provide supervision and assistance with your loved one's health and personal care needs, but, just as importantly, can provide companionship and appropriate outings and activities. This frees family to take some time for themselves. We all need a break, especially dementia caregivers!
7. Be flexible. Your loved one may have good days and bad days; an activity that was well-received on one day might cause frustration and agitation the next day. Which times of day are best for your loved one? (Often, mornings are the best.) Let visitors know that you might have to cut a visit short. This is another area where meeting your loved one where they are is the most effective policy.
Memories may fade, but warm feelings last.
"What did you do on your outing with Cousin Alex?" "Nothing…" Yes, your loved one will sometimes promptly forget an event. But, say experts, while specific memories may fade, the overall feeling lingers. In a series of studies, University of Iowa researchers have shown that even when people with dementia are unable to remember an activity or social event, positive emotions and warm feelings can persist for days. Said head researcher Justin Feinstein, "A simple visit or phone call from family members might have a lingering positive influence on a patient's happiness, even though the patient may quickly forget."
The National Institute on Aging offers helpful tip sheets for caregivers whose loved one has dementia, including information about communication, helping family and friends understand the changes in your loved one, and suggestions for daily activities.