Always remain calm when supporting ADL and IADL. Gentle statements such as “We are going to go for a walk now—put one foot in front of the other” or “I will hold the cup while you put your coat on” can redirect and minimize agitation. Validate feelings, for example, “I see you are uncomfortable—let me check the front of your shirt.” Let the person see you as a humble ally.
Self-Assessment Quiz Question #4 What is aphasia? a. Fainting. b. Loss of language and impaired comprehension. c. Loss of balance. d. A tingling sensation.
COMMUNICATING WITH ADRD PATIENTS
ADRD patients can have impaired communication and language (Mueller, 2018). These challenges become evident with word retrieval. As the disease progresses, the person becomes unable to recall words, which can result in unintelligible words that make delivering care and support challenging. Additionally, struggles with word retrieval often prompt frustration and agitation that can develop into behavioral issues as the person tries to express themselves. Evidence-Based Practice! Communication with people with ADRD is imperative, and as the disease progresses there will be a reliance on a caring support network. It is incumbent on the professional to accommodate communication needs and styles through progression of the disease. Share ideas and feedback with colleagues to identify innovative ways to communicate with people with ADRD in a manner that is dignified and effective (Alzheimer’s Association, 2022).
The term aphasia refers to the loss of language and impaired comprehension, including reading and writing, as an outcome of the breakdown of neurons (Weekes, 2020). It is important to note that memory loss may present before aphasia. As ADRD progresses the person may have clear difficulty speaking clearly and retrieving words pertinent to the conversation at hand. The person may repeat stories, situations, or words because that is language they can access. They may use words incorrectly and begin using descriptive language rather than names, and they may lose their thoughts mid- sentence. People may revert to their native language and ultimately may avoid speaking and engaging in conversation. Their difficulties with language may result in frustration and anger—be patient.
BEST PRACTICES: CARING FOR THE PATIENT WITH ALZHEIMER’S DISEASE
As AD progresses daily care challenges related to hygiene, such as bathing, can present (Alzheimer’s Association, 2022). There are many reasons for this—people may not want to share that type of intimacy, or the person with AD may have a fear of water, which, combined with eyesight challenges, may be overwhelmingly scary. Limitations in communication may also
prompt frustration and resistance to bathing. Tables 4 and 5 provide further implementations and suggestions for caring for the patient with Alzheimer’s disease. For further insight and suggestions for care, join ALZConnected, a virtual support community for caregivers.
Table 4. Communication Strategies Communication Strategies
Steps
Be patient
• Listen • Provide time for dialogue
• Avoid rushing • Don’t interrupt • Install a “pause” before reacting to impulsive or unexpected communication or behavior from a person with ADRD • Pay attention to context • Recognize that actual words may not correlate with what the patient is trying to communicate • Offer suggestions, but don’t overwhelm with too many choices • Do offer choices to give a sense of control (e.g., “Do you want to go for a walk now or after lunch?”) • Use visual cues (e.g., if the person is cold but cannot express it, show them a sweater) • Keep language simple and avoid cultural slang
Listen and interpret
Pay attention to body language
• Look at the person when they are talking • Don’t correct • Maintain eye contact • Have a connection; hold a hand (if permitted)
• If the person seems bored or disinterested, or appears to need to move around, follow their lead—go for a walk, perhaps move from the space you are in and go outside, listen to light music
Be respectful
• Don’t correct • State your interpretation of what they are expressing • Don’t argue or challenge • Recognize your nonverbal cues • Remain calm and relaxed • Avoid speaking with child-like reference
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Book Code: PYIL1824
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