Tips for Caring for a Person with an Impaired Memory
Courtesy of Geriatric Assessment Program, University Geriatric Center, Omaha, Nebraska. - Memory aids, such as clocks, calendars and simply-worded notes, may help the person remain oriented.
- Much of what you say to the person may soon be forgotten. Be prepared to repeat yourself, sometimes often.
- Use a calm voice and respond to a question with brief, simple statements. Try using touch and direct eye contact when responding in order to emphasize what you say. Avoid presenting the person with more than one thought at a time, and limit choice options ("Either this or that").
- Distract the person from an irritating or repetitive topic by using a word from the conversation to change the subject. Try such pleasurable distractions as taking them for a walk or drive, looking through family photos, playing music or giving the person a simple repetitive task to perform, such as folding towels.
- If distractions fail, try ignoring repeated questions. This may anger or agitate the person, but the questions may stop if they are not reinforced by your behavior. Ignoring may be an especially good idea when you are irritated. It may keep the person from picking up on your angry tone of voice.
- Most memory-impaired persons function best when they follow a familiar routine in familiar surroundings. Avoid abrupt and frequent changes of routine, location, and social situation. Avoid discussing plans for activities or appointments until just prior to the event so the person does not worry and ask repeated questions days ahead of time.
- Allow the person to do as much for themselves as they possibly can, even if they are slower and less efficient. Positive reinforcement and praise helps them maintain social and self-care skills. When correcting or directing them, avoid negative commands ("Don't do…"). Use the positive focus ("Let's do…").
- If the person's memory skills continue to worsen over time, closely monitor their performance of tasks and be prepared to lower your expectations for their performance. Try to take over a task completely only when they cannot perform it even with step-by-step instructions or help. Tasks that involve complex reasoning or present safety problems (such as driving, using appliances or managing financial affairs), may have to be assumed by others sooner rather than later.
- While you should honestly acknowledge to the person that he/she has a memory problem, confronting the person with their loss of ability may lessen their sense of dignity and self-esteem. Try to remind the person how much they can still do for themselves. Reassure them that they are still loved and valued.
- To include the person in social conversations, refer to positive memories of the past. Don't discourage reminiscence, as the person is better able to remember past events than they are present ones.
- Suggest a word or name the person may be searching for in conversation, but avoid correcting mistakes already made. Contradicting or arguing with the person may only cause upset and humiliation.
- Prevention is the most effective approach to reduce behavior problems. Anticipate and avoid activities and discussions that will provoke anger or agitation.
- Try to determine a reason for a troublesome behavior. Is the person trying to communicate feelings of fear, pain, hunger or the need to toilet? Respond to the need or emotion you feel the person is trying to express.
- If the person becomes extremely agitated or verbally or physically threatening, remove him/her from the stressful situation or place. Try to calm the person with slow movements, a soothing and reassuring voice and gentle touch. Do not try to reason with the person, as their ability to understand logic and reason is impaired. If you feel threatened, remove sharp or dangerous objects from the area and stay out of reach. Leave and seek help if necessary.
- Make note of when a catastrophic reaction occurs. Is there a pattern - such as, time of day, type of activity, specific person -- that can be identified? Simplify the environment by reducing extra people, clutter, noise and activity. Soft music or holding a doll or a stuffed animal may ease agitation and calm fears in a severely impaired person.
- While use of medication to control behavior should be avoided, medications may be necessary to control depression, hallucinations, paranoia, sleeplessness and extreme agitation. Discuss this with your doctor.
- Try to discuss openly and honestly the person's memory and behavior problems with family, friends, neighbors and others who will have regular contact with him/her. People tend to respond more appropriately and offer assistance when they understand the situation.
- Emotional support and respite from caregiving duties are essential to helping you cope. Arrange for someone else to assume your caregiving duties for several hours at a time on a regular basis so you can get out and "recharge your batteries." You can not provide good care for your loved one if you neglect your own needs.
- Consider joining a self-help or support group. These offer an excellent setting in which to express your feelings and learn creative approaches to solve the challenges you face in providing care. Your local Area Agency on Aging or regional chapter of the Alzheimer's Disease Association can direct you to such groups.
- Be patient with yourself. Recognize that you will make mistakes and will become angry and impatient at times. Know your own limits and try not to feel guilty when you have to say "no" to others. Remember, you are only human!
(Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.)
For further information about Alzheimer's Disease or related disorders, contact the Alzheimer's Association at: