Try: Avoid correcting cr for example avoid saying something like no john it is not friday it is sunday try saying something like this it it’s your friday huh what do you do on fridays

Materials: n/a

Categories: Sage, Topic, Communication, Independence, Some Supervision, Maximum Supervision, Cognitive Awareness, Somewhat Aware, Unaware, Long-Term Memory, So-So L T Memory, Poor L T Memory, Short-Term Memory, So-So S T Memory, Poor S T Memory

Information: n/a

References: using validation therapy to manage difficult behaviors by jan allen no date available at www alzwell com

Keywords: Condused days weeks time warp memory loss

*This information is listed as a Tip and is not explicitly medically licensed

Try: Avoid correcting cr for example avoid saying something like i am too your wife try saying something like this if you say so but i’d like to be your friend

Materials: n/a

Categories: Communication, Personal, Independence, Some Supervision, Maximum Supervision, Cognitive Awareness, Somewhat Aware, Unaware, Long-Term Memory, So-So L T Memory, Poor L T Memory, Short-Term Memory, So-So S T Memory, Poor S T Memory

Information: n/a

References: using validation therapy to manage difficult behaviors by jan allen no date available at www alzwell com

Keywords: Confused doesn’t recognize people memory loss

*This information is listed as a Tip and is not explicitly medically licensed

Try: Communicate with the cr in a tactful and thoughtful manner learn and apply appropriate communication techniques avoid arguing confrontations or trying to logically convince cr of something avoid relying solely on what cr tells you corroborate each story or event as needed validate cr’s feelings concerns and experiences even if they don’t match with reality correcting only causes upset – cr won’t reorient to remembering it later look for and respond to the meaning behind cr’s words e g asking about someone may mean cr misses them and has a need to reminisce or has a need to connect with something reassuring familiar safe etc avoid quizing cr; instead sk about his her thoughts and feelings

Materials: n/a

Categories: Communication, Medical Physical, Personal, Verbal Communication, So-So Verbal Comm, Poor Verbal Comm, Cognitive Awareness, Somewhat Aware, Long-Term Memory, So-So L T Memory, Poor L T Memory, Short-Term Memory, So-So S T Memory, Poor S T Memory

Information: n/a

References: planning guide for dementia care at home a reference tool for care managers by the alzheimer’s association, south central wisconsin chapter the wisconsin alzheimer’s institute and the wisconsin bureau of aging and long term care resources division of disability and elder services department of health and family services 2004 available at www dhs wisconsin gov

Keywords: Communication repetitive speech repeats word talks in circles says the same thing over and over memory loss disoriented

*This information is listed as a Tip and is not explicitly medically licensed

Try: Suggest that cr try to see the humor in being in his her situation suggest that cr write on a card have you laughed today and place it in a conspicuous place in the bathroom or kitchen this will help remind cr to laugh or find something funny to enjoy help cr find and read funny books or jokes listen to funny tapes or watch humorous movies or videos that make him her laugh; suggest that cr share something humorous with a friend or relative encourage cr to attend social groups where there is a lot of comeraderie joy and fun; suggest that cr be aware of how often he she smiles; then remind cr that it takes much less energy to smile than to frown

Materials: Index card pen joke books comedy tapes cds videos

Categories: Sage, Topic, Communication, Emotional Psychological, Personal, Social

Information: n/a

References: caregiver’s handbook by the caregiver education and support services seniors counseling and training case management services of the san diego county mental health services no date available at www acsu buffalo edu

Keywords: Humor laugh laughter smile humorous stress

*This information is listed as a Tip and is not explicitly medically licensed

Try: Allow the cr to express fears of death it can be difficult to hear a cr talk about leaving family and friends behind but communicating their fears can help them come to terms with what’s happening although it will be difficult try to listen keep the cr company talk with the cr read to her watch movies together or simply sit and hold their hand refrain from burdening the cr with your feelings it is ok to speak about your feelings with the cr but you should not trouble the cr you can always talk to someone else about your feelings allow the cr to reflect talking about their life and the past is another way some crs gain perspective this also allows the cr to accept the process of dying avoid withholding difficult

Materials: n/a

Categories: Communication, Emotional Psychological, Medical Physical, Personal

Information: If they’re still able to comprehend most crs prefer to be included and informed honor the cr’s wishes reassure the cr that you will honor their wishes such as advance directives and living wills respect the cr’s privacy honor privacy as much as possible this is a way to keep dignity as long as possible information

References: Helpguide org

Keywords: Late stage care end of life

*This information is listed as a Tip and is not explicitly medically licensed

Try: If available join a caregivers’ bereavement support group being with others who know your situation can help you understand your feelings enroll in an adult education class or volunteer if you have new free time acquiring new skills and staying physically active can promote healing create lasting tributes to the cr consider memorial sites scholarships or gifts to charity if you want to honor her life if you caregive often take time away if you need it rest and reflect share the cr’s unique story with family members and other caregivers keep a journal writing down thoughts and feelings can provide a release for your emotions talk to a therapist or grief counselor they can be a good resource if you are having difficulty after the cr’s passing

Materials: n/a

Categories: Communication, Emotional Psychological, Medical Physical, Personal

Information: n/a

References: Helpguide org

Keywords: Late stage end of life

*This information is listed as a Tip and is not explicitly medically licensed

Try: Respond to the emotion instead of the specific question cr may simply want reassurance use brief statements try not to remind cr that he she has asked the same question before as this may be upsetting to him her try a gentle touch when verbal response does not help use a calm voice when responding to repeated questions use simple written reminders if cr can still read try not to discuss plans with cr until just before the event if this causes agitation and repeated questions ignore the behavior if there is no response or reinforcement the behavior may stop redirect cr’s attention to focus on a simple task or activity such as looking at a magazine picture book or tv

Materials: Pen and paper magazines or picture books

Categories: Sage, Topic, Communication, Emotional Psychological, Medical Physical, Independence, Some Supervision, Maximum Supervision, Verbal Communication, Good Verbal Comm, So-So Verbal Comm, Poor Verbal Comm, Cognitive Awareness, Somewhat Aware, Unaware, Long-Term Memory, So-So L T Memory, Poor L T Memory, Short-Term Memory, So-So S T Memory, Poor S T Memory

Information: n/a

References: mental health mental illness healthy aging a nh guide for older adults and caregivers by nami nh 2001 available at www nami org

Keywords: Repeats repetition annoying behavior challenging behavior distracted distractions memory loss verbal communication

*This information is listed as a Tip and is not explicitly medically licensed

Try: Engage cr in his her favorite activities reminisce about past events that cr is more likely to remember play music with a strong tempo and encourage cr to clap or stomp his her feet acknowledge cr cr’s feelings realize that he she may be feeling grief over physical and mental losses due to a medical issue or grieving over deceased loved ones use simple humor such as a book of jokes or old tv comedies to lighten things up consider enrolling cr in an elder care program that engages cr in appropriate activities

Materials: n/a

Categories: Sage, Topic, Communication, Emotional Psychological, Medical Physical

Information: n/a

References: managing challenging behaviors in people with alzheimer’s by mayo clinic on alzheimer alzheimer’s disease petersen ronald ed 2002 available at www christianacare org

Keywords: Indifferent indifference apathy depressed depression needs cheering up blank stare stares into space lack of motivation doesn’t want to do anything grieving over death of loved one grief loss of spouse helplessness gloomy needs goal directed activity

*This information is listed as a Tip and is not explicitly medically licensed

Try: Use good listening skills keep eye contact and use touch to reassure and show interest in what cr is saying show interest in what cr says and feels pay attention to his her voice and gestures to better understand his her feelings keep in mind that emotions are sometimes more important than what is being said if it is difficult to understand what cr is trying to say ask him her to point or gesture if cr is having difficulty finding the right word offer a guess if cr uses the wrong word and care giver cg knows what is meant go ahead and supply the correct word if this upsets cr do not correct him her next time or in the future if cr is upset but unable to explain it verbally give comfort and reassurance cr may become more upset if he she is pressured to explain

Materials: n/a

Categories: Sage, Topic, Communication, Emotional Psychological, Medical Physical, Verbal Communication, So-So Verbal Comm, Poor Verbal Comm, Cognitive Awareness, Somewhat Aware

Information: n/a

References: communicating with your loved one who has alzheimer’s by mayo clinic on alzheimer alzheimer’s disease petersen ronald ed 2002 available at www christianacare org

Keywords: Disoriented speech communication communicating jumbled speech talking conversation confused speech jumbled words trouble expressing with words verbal verbalizing

*This information is listed as a Tip and is not explicitly medically licensed

Try: Common symptoms in end-of-life care drowsiness plan visits and activities for times when the cr is most alert becoming unresponsive many crs are still able to hear after they are no longer able to speak confusion about time place and persons speak calmly and slowly to help to re-orient the cr gently remind the cr when needed loss of appetite decreased need for food and fluids let the cr choose if and when to eat or drink keep the cr cr’s mouth and lips moist with products such as glycerin swabs and lip balm loss of bladder control keep the cr as clean dry and comfortable as possible place disposable pads on the bed beneath and consider adult diapers if needed skin becoming cool to the touch warm the cr with blankets but avoid electric blankets extra layers labored breathing breathing may be easier if the cr cr’s body is turned to the side and pillows are placed beneath the head and behind the back find a comfortable position

Materials: n/a

Categories: Communication, Emotional Psychological, Medical Physical

Information: n/a

References: Helpguide org

Keywords: End of life late stage symptoms

*This information is listed as a Tip and is not explicitly medically licensed