Just the Facts and More: Visiting

Visiting allows you and the person with Alzheimer's disease to enjoy the company of others. Maintaining social contacts takes extra planning and effort by the caregiver. As the caregiver, you can assist family and friends with ideas to make visits meaningful, comfortable, and to use communication techniques which will enhance their interactions with the impaired person.

Often times people may hesitate to spend time with the person with Alzheimer's because they worry about not knowing what to do or say. Others may not understand the behavior changes that are caused by the disease, and feel uncomfortable about visiting.

By working through the concerns of friends and family members, you can continue to give yourself and the person with Alzheimer's an important social outlet. Here are some tips to assist you in having visitors to your home and visiting outside of your home.

Action Steps

Invite visitors to your home.

• Don't wait for friends and family to ask if they may stop by for a visit. Instead, take the initiative to contact them and explain that while Alzheimer's Disease has changed your lives in some ways, you value their friendship and support and want it to continue. Then suggest a time when they might come over.
• Plan for a successful visit. While the visit certainly doesn't need to be perfect, it should be relaxing and comfortable for everyone: visitor, caregiver, loved one, and other family members.
• Prepare visitors before the visit. Educate visitors about how the person with Alzheimer's may have changed - physically, emotionally, and intellectually. Mention specific changes in behavior such as fidgeting, wandering or incontinence. Provide suggestions about how to communicate more easily with the person, by talking to him/her one-on-one, or by understanding that (s)he may repeat things, or ask the visitor a question already answered. This information can help lessen the visitor's anxiety.
• Clarify the purpose of the visit. Some people are reluctant to visit because they don't want to be drawn into the heavy responsibilities of caregiving. Be sure to mention that the purpose of the visit is purely social and not to relieve you of caregiving. Make sure that visitors know that their time is a momentary gift of love to the person and a gift of support to you.
• Suggest specific activities such as taking the person to lunch, sitting on the porch, taking a walk, or looking through a photograph album together.
• Remain accessible to visitors. One of the greatest fears visitors have is that they will be left alone to communicate with or care for the person with dementia. If you are close by, visitors can share specific questions or problems with you. Visitors also may want the chance to talk to you.
• Adjust the nature of the visit to the visitor. Some visitors feel they must do or bring something in order to make the visit worthwhile. You may want to suggest that these visitors bring flowers or special cards, read a chapter from a favorite book, or sing a special song. It is important that they conclude the visit feeling they have delivered something of value to you and to the person.
• Communicate with potential visitors regularly or ask them to confirm visits by calling ahead. Inform visitors that the person's condition may change from month to month, week to week, or day to day. For example, it may be better for some patients to have morning visitors, while other may benefit from late-afternoon visits.
• Be patient with people, and encourage people to be patient with the impaired person. Practice forgiveness. Even people in such caring professions as social work or pastoral care may have difficulty coming to terms with Alzheimer's. Some people whom you thought you could depend on may avoid you, while others may rally to your side. Try not to take negative reactions personally.
  

Visiting others' homes

• Prepare your host/hostess for the visit. You may want to explain that your visit may be relatively short, or that in the middle of it you may need to take a walk or shift the person's focus to another activity. You may want to bring along a favorite album, book, or audiotape to help occupy the person.
• Think of a visit as a brief vacation. Unlike vacations that often involve changes in food or surroundings, visits to others' homes provide you with a sense of "normal" life, a link with the past, and a brief, memorable time with friends or family.
• Take pictures of friends and relative to preserve a happy memory for yourself and the person.
  

Visiting the nursing home

• Get acquainted with the staff. Ask questions about special problems or changes involving the person with Alzheimer's. For example, the Activity Therapist on staff may provide you with suggestions for new activities of interest to your family member.
• Get to know other residents. Your frequent visits to the nursing home bring you into contact with many residents who may not know you personally, but may appreciate your presence.
• Depending on your time constraints, you may want to get involved with other nursing home activities, such as becoming a member of a family council, a group which works with the nursing home staff.
• Prepare friends and family members for nursing home visits. Explain how the person's condition has changed and how long of a visit (s)he can handle. Also suggest simple activities such as giving the person a simple gift, putting lotion on his/her hands, or reading a poem or story aloud. A visit to the nursing home gift shop can be enjoyable.
• Ask visitors to leave a card or note when they have visited, or provide a guest book in the person's room that they can sign. Nursing home staff may not remember who has visited in your absence. If you know visitors' names and the times of their visits, you can make a point of extending a personal thank-you.
  

Making office visits

• Before taking the cognitively impaired person to a professional office - to see a doctor, for example - work with the office staff. Advise them that the patient has dementia, and explain that the person's attention span is short and that time spent sitting in the waiting room should be limited. Ask if you may wait in an empty room. Also ask staff about parking, distance to the building, and accessibility of stairs and elevators.
• Be assertive about appointment times. Based on the person's daily routine or "best times," insist upon a morning or afternoon appointment. If the staff knows the situation, they may be willing to give you an appointment when the office is less crowded or noisy. Consider calling the office before you leave the house to check if the doctor is on time.
• Never leave the person alone in a waiting room. Consider taking a third person with you who can drive and help keep the person occupied. It is helpful to offer extra reassurance to the person with Alzheimer's because (s)he is away from the familiar environment.
• Plan for possible waiting. Even if you plan ahead, you may have to wait longer than expected. Handle the person's hunger by bringing along nutritious snacks. Take a walk down the hall or to another floor of the building. Keep the person busy with a deck of cards or looking at a magazine. Don't worry if the person fidgets or paces. His/her anxiety is normal.
• Use common sense in preparing the person for the visit. Instead of providing an elaborate explanation, simply say, "We're going to see Dr. Jones today." If the person with Alzheimer's objects, avoid getting an argument by offering a positive suggestion such as, "I need your help in explaining things to the doctor."

By preparing friends to visit the family member with Alzheimer's in any setting, you can make the visit comfortable, enjoyable, and an important part of the life of your loved one and family friends. Remember to show your appreciation to friends and family for providing you support and for visiting with your loved one.

Resources

One of the best places to turn for additional help is the Alzheimer's Association. The Alzheimer's Association has more than 83 Chapters and 1,600 support groups nationwide, where family members of people with Alzheimer's disease or a related disorder share their experiences, provide each other with emotional support, hear practical suggestions and learn to rebuild their lives.

The primary resource for this fact sheet was Cindy Ulm, Regional Delegate, Board of Directors, Alzheimer's Association, Indianapolis, Indiana.

Special thanks to the following Chapters of the Alzheimer's Association: Columbia Willamette, Dallas, Los Angeles and Northern California.

© 1992 Alzheimer's Disease and Related Disorder Association, Inc. All Rights Reserved

Compiled by the Lincoln/Greater Nebraska Chapter of the Alzheimer's Association, 1999.