“I don’t think anyone’s ever won an argument with a person with Alzheimer’s,” says Ruth Drew, who worked as a counselor in a hospital’s geriatric psychiatric ward before becoming a director with the Alzheimer’s Association, where she oversees the 24-hour 1-800 help line. Drew’s grandfather was afflicted with the degenerative brain disease. He would often get up before 2 a.m., sure it was morning. No amount of showing him the clock or pointing to the darkness outside could persuade him otherwise. “Everything you know about persuasion and logic you have to put on the shelf,” she says.
Be patient, calm and kind. You cannot predict how the plaques and tangles in an Alzheimer’s patient’s brain will change him or her: A taciturn mother becomes chatty, a father forgets his daughter, a prim grandmother takes up obscenities. Drew’s father, who has midstage Alzheimer’s, can entertain partygoers with jokes but can’t remember how to get home. Some people die within a year of diagnosis, and others live with the disease for decades. Approach someone with Alzheimer’s from the front. If the person doesn’t recognize you, say your name. Position yourself at eye level and connect with the person as he or she is, right now, before you. “Treat them with the respect that a lifetime of experience on this earth deserves,” Drew says.
The disease slows the brain. Speak clearly. Use words sparingly. Gesture more. If you want to offer coffee, instead of blathering, place two cups of coffee on the table and beckon toward the empty chair. “Coffee?” As language comprehension begins to fail, you’ll need to become something of a detective, looking for other cues like facial expressions, grunts and sighs that hint at needs or states of mind.
Some 5.8 million Americans currently live with Alzheimer’s, a figure projected to more than double by 2050. Even when patients can no longer speak or recognize family members, they still need human connection. Drew likes to encourage the families she works with to think about how to show that bond in ways that don’t rely so heavily on language. Hold their hand. Play their favorite song. Take them outside to feel the wind on their face. Sing to them. One man Drew knows shaves his father’s face for him. “It’s something they both enjoy,” she says. “They don’t need words.”