On the list of issues caregivers find hardest to deal with, withdrawal is one of the most challenging. If a loved one begins a sentence and suddenly finds she can’t come up with a word she needs, she’ll probably hesitate to speak up next time. If she asks a question and is told she’s already been given the information she wants, many times in fact, she may decide to live in ignorance rather than ask questions. When she sees a familiar face in a family gathering but can’t identify the person by name, much less relationship, it’s easy to understand why she might retire to a corner.
Because it’s so easy to imagine why someone with Alzheimer’s would shrink from social interaction, it’s difficult, at least at first, to see how to keep them connected to family and friends.
One of the first things I learned as a caregiver had to do with this very issue. Soon after my mother began displaying symptoms of dementia, experience convinced me that keeping her as involved as possible in the current moment was beneficial. Her mood was more stable and her mind less confused when we kept her attention focused on the activity around her. But I watched her interact less and less day by day.
So what can we do to keep our loved ones “present” in our lives – and their own – for as long as possible? Here are some suggestions.
Talk to – not around – your loved one. As Mom lost the ability to carry on conversation, I realized Dad and I were prone to talk around her. Sometimes, eyebrows raised, she leaned forward in her chair, looking at us, smiling broadly when she caught someone’s eye. I thought she might need something, but when I asked she shook her head. Did she have something to say? No. She kept smiling but said nothing.
I tried to remember for her: what did her conversations look like? Before Alzheimer’s, a wink, taps on my knee under the table, and “secrets” whispered in my ear were trademark facets of a conversation with Mom. So as Dad and I talked, I smiled at her, winked, and sometimes whispered comments to her. And it worked, at least sometimes. She stayed with us instead of retreating to her couch. She smiled when we smiled, frowned when our voices got more serious, and sometimes even interjected a comment.
Talk simply. In the middle of a conversation with Dad on the economy, I’d take a break to ask Mom a simple question, like “Do you like my earrings?” Sometimes she answered. But even if she didn’t, I continued to talk directly – and only – to her. “I wasn’t sure they’d go with this color, but I think they’re okay, don’t you?” I learned not to say too much at one time; Mom tended to lose track and get nervous. I also learned to brace myself for her sometimes unkind or critical replies. But often such an interruption to my talk with Dad reaped sweet rewards: a smile, maybe a pat on the hand, sometimes even that “connected” look in her eyes.
As far as possible, stick with the familiar. The more familiar the surroundings, the people, the activity, the more comfortable your loved one will be. For Mom, being at home eating a meal with Dad, and maybe my sister and me and our husbands, was clearly easiest for Mom to enjoy. Eating a meal with me and Dad at the super-center was good, too. Mom’s comfort didn’t extend far beyond those boundaries.
Pets are good. If you don’t have a pet, the onset of Alzheimer’s probably isn’t the best time to get one. But if your family already includes one, you probably know what a help they can be. My parents had Charley-Dog, a usually scruffy but sometimes quite handsome silver miniature poodle. Charley was a sweet constant in Mom’s days.
He offered warmth and affection without making any demands on her memory or requiring any cooperation from her. He could make her smile when nothing else worked. Even when she refused to speak to me and Dad, Mom could always interact with Charley.
If someone lives long enough with Alzheimer’s, their virtually complete withdrawal from the world around them is inevitable. But there are ways to keep them “with us” longer. Yes, in this area as in most issues associated with Alzheimer’s, we’ll be operating on a trial and error basis: maybe this way will work, maybe not; maybe it won’t this time, but it might next time. Still, in my experience, the effort is well worth the expenditure of time and creativity. I strongly believe that the chance to express herself in an easy way, with a nod or a yes or no answer, let Mom feel some power. I think it helped her maintain her place in the family.
Though I have fallen, I will rise.
Though I sit in darkness, the LORD will be my light (Micah 7:8 NIV).
You are our strength, Lord. You show us the way when all seems lost. You keep us trying when we might give up. Bless our loved ones, Lord, and inspire and enlighten our efforts to help them.