Persuasion Techniques for Dementia Caregivers
THE ART OF PERSUASION by PAM OSTROWSKI
If you’re a family member interacting with your loved one with Alzheimer’s, it’s pretty safe to say you’ve gotten frustrated with how to get them to do tasks that seem pretty straightforward to you. Here are some examples of persuasion techniques for dementia caregivers that will help avoid frustration on both your parts.
It is common for those with early-stage Alzheimer’s to not recognize they have the disease, creating the potential for some difficult conversations. The medical term for this is anosognosia. With anosognosia, there is a limited ability to have insight into one’s abilities, which can impact memory, general thinking skills, emotions and physical abilities. If you believe your loved one with Alzheimer’s should not be driving, then it’s important for you to have the conversation from their perspective, both in your mindset and your words.
Many caregivers tell their loved one, “We have to take away the keys.” This wording communicates a mindset of authority, superiority, control and a judgment that the loved is incompetent. Instead, adjust your mindset to “aging seniors can be victims of many threats while driving.” Note that this is not saying, “Mom/Dad/Spouse, you’re a danger to others while driving.” Would you want someone to say that to you?
Have a courteous conversation with your loved one. Point out the vulnerabilities that exist for them (e.g., flat tire, someone hits their car either accidentally or on purpose, carjacking their valuable car, a person crossing the street between lights, etc.). Avoid talking about their driving skills and instead ask them how they would handle each of these threatening situations. Express concern about them being harmed, not them harming others, which could cause resistance. Ask them what their biggest concern is with not having a car and then discuss options to address that concern. Ask if they’d be willing to try it for a month. Lastly, express how badly you would feel if something tragic happened to them. They’ll feel loved and needed versus feeling scolded and treated like a child.
LEAVING THE HOUSE
Depending on your loved one’s stage, you might meet with resistance when it comes to their leaving the house, especially for social situations.
It’s common for someone who is struggling cognitively to feel embarrassed about their condition and fear embarrassing family. It’s safer to stay home and isolated. However, that’s not good for their brain health.
• Keep it simple
It’s best to keep leaving the house simple. So often, family will say, “Dad, we have to go to your doctor’s appointment at 10 a.m. Get ready. We’ll leave at 9:30 and stop at the bank.” That’s too much information, and some of it is vague. What does “get ready” mean? What time is 10 a.m.? Keep it simple. Less information can be better.
• When in doubt, act it out.
“Dad, let’s put on our shoes so we can go out.” Bring his shoes and set them down next to him and bring yours, too. Put on your shoes to show him what he needs to do. After everyone’s shoes are on, do the next step, whatever that might be. There’s no need to overshare where you’re going (“out for a drive” is fine) and when. That information may cause resistance, so it’s best to keep it to yourself. Note that most of the struggle comes from using wording that the person with Alzheimer’s doesn’t recognize. So, get creative. Keep your sentences short and simple. When in doubt, act it out.
As Alzheimer’s progresses, activities of daily living, such as eating, can be challenging.
• Over and under can both be unhealthy
If a person with Alzheimer’s is living alone, they may not eat because they think they already did. They may overeat because their satiety cues may be off, so they’ll start to gain weight. Over medicating or under medicating may also happen, which can result in serious health issues.
• Likes and dislikes change
It’s important that you not assume your loved one has the same tastes and likes they once had. They are becoming a new person with new likes and dislikes. Allow them to try things as if they are completely new. Nutrition may also get compromised because sweet things taste so much better than veggies and protein. Plus, veggies and protein require remembering how to shop for and prepare a meal. A bag of candy bars is so much easier to buy and eat. There is also the challenge in mid-to-late stages of your loved one not recognizing eating utensils. That’s why communal eating is successful for those with Alzheimer’s. They can mirror what others are doing at the table. Even recognizing toothpaste vs. another tube may become difficult. Understanding what a toothbrush does and why one should use it may be difficult. If your loved one is refusing to brush their teeth, join them. Make it an activity where you both brush your teeth, with you (or a caregiver) helping with setting up the toothbrush.
ABOUT THE AUTHOR
Pam Ostrowski is the CEO of Alzheimer’s Family Consulting (AlzheimersFamilyConsulting.com) and the author of It’s Not That Simple: Helping Families Navigate the Alzheimer’s Journey.