If you got in the elevator with someone who has dementia would you say something friendly or look away? If you’re like most people, you might avoid making conversation. “People tend to generalize any kind of cognitive challenge to be Alzheimer’s so there’s a huge stigma attached,” says Heather Palmer, National Director of Cognitive Well-being for Amica. “They assume and fear the worst so they don’t reach out.” Learn to connect using these tips from Amica’s renowned memory care expert.
Step 1: Accept aging in the body and mind
When she’s making presentations about memory loss, Palmer tries to reduce the stigma by comparing cognitive with physical aging. With physical aging, she observes that most of us seek solutions: we wear sensible footwear, get prescription eyeglasses or use walkers. “We accept that we become more physically frail as we age,” she says. “We may not like it, but we find tools to adapt.” The body’s organs also decline over time: we may have to get up in the night to use the bathroom and our hearts don’t pump blood as well as they used to.
Palmer reminds us that the brain is just another organ. “How many people can hear, see and run as well as they could at age 20? It’s unreasonable to think that our brain will be as good as ever.” When she asks a room full of people to nod if they’ve ever had trouble remembering a name or forgotten where they’ve left their keys, she winds up looking at a room full of nodding heads. “Yet somehow we are less accepting that, as the brain ages, there will be functional changes affecting how we think,” she says. “Some of us face more physical challenges and others face more cognitive challenges caused by brain changes. Why do we treat people differently for one and not the other? None of us have asked for any of these changes.”
Step 2: Understand some of the impairments caused by memory loss
Some residents in Memory Care neighbourhoods at Amica are as fit and physically capable as other seniors. They may go to exercise classes, engage in activities and outings and manage activities of daily living just as others do. “Cognitive impairment is often misunderstood, especially when someone looks and functions so well physically,” says Palmer. “It’s our job to support their cognitive well-being so they continue to get as much meaning and purpose out of life as possible.”
Age-related changes in thinking may affect memory, organization, word finding and multitasking. People with dementia may have trouble processing information, impacting their ability to understand, express their own feelings and communicate in general. As a result they may act in unconventional ways. “Try not to judge,” suggests Palmer. “All behaviours, whether positive or negative, are an expression of some kind of need. The need just may not be immediately obvious.”
Step 3: Be a good neighbour
- Go ahead, say something! “People assume the worst and are afraid. They might think, ‘That person seems happy sitting there so I’m not going to go over to talk because I might trigger a bad reaction,’” says Palmer. “Often they choose not to interact when that very interaction could bring more meaning to that person’s life.”
- Approach from the front so you don’t startle anyone. It also helps to interact at eye level.
- Don’t talk like the person is a child but do slow down and simplify the message. Some may not be able to understand and others will.
- Support with visuals. You might use your hands to mimic the act of eating or point to a necklace while offering a compliment.
- Above all, be nice. Even if you don’t say anything, Palmer suggests starting by offering a big smile. “People who are cognitively compromised will pick up and absorb the feelings of those around them. If you’re friendly, smiling, showing warmth and kindness, the person may not understand what you’re saying but they will remember how your warmth made them feel good. They will likely give you a big smile back.”
Dr. Heather Palmer is a cognitive aging and dementia specialist with more than 30 years of clinical and scientific experience. She focuses on helping individuals improve the way they think, feel and function. As Amica’s National Director of Cognitive Well-Being, she develops cognitive well-being programs for Amica with a heightened focus on memory care and assisted living.
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