As a loved one struggles with Alzheimer's disease, family members grapple with how to effectively and calmly communicate.
The first thing to remember is that the person with a disease like Alzheimer's or dementia is not being difficult on purpose. They are truly doing the best they can, said Renee Chase, community outreach coordinator for the Alzheimer's Association of Greater Kentucky and Southern Indiana.
But keeping that in mind is not easy.
"It is a really hard thing," she said. "When you have always related to a person in a certain way and all of a sudden that changes, it is a really hard adjustment," she said.
Employing her experience with strategies developed by the Best Friends model, Chase has suggestions for caregivers. Best Friends is a day program that provides dementia care for people with irreversible memory disorder and their families. It was created in Lexington by Virginia Bell and David Troxel.
As the disease progresses, certain functions of the brain are affected more than others. The portion of the brain that accessed languages is affected, meaning patients have fewer options to express themselves, she said.
People with Alzheimer's might have difficulty finding the right words, or they might use the same word repeatedly, invent new words or even use curse words that they never would have spoken before.
They might revert to speaking a native language, speaking less or relying on gestures instead of words. They are using the neurological tools they have left, she said, but their options are diminishing.
Family and friends should do their best to be patient and look for ways to help the person with Alzheimer's to use the language tools they still have. Try to avoid criticism and correcting, Chase said. Arguing with a person with Alzheimer's isn't going to get you anywhere.
The closer you are to the person who is suffering from the disease, the more frustration it can cause.
One of the many reasons it's important for people to remain calm when dealing with an Alzheimer's patient is that although they may lose their ability to speak, they often retain the ability to read body language and respond negatively to a tense or loud voice.
The caregiver needs to tune in to the body language of the person with the illness to help figure out sources of frustration.
"It's one of the big, big pieces of all this," she said.
But it's not all negative.
"The spark of humanity that makes them who they are never goes away," Chase said, so it's important to find a way to nurture that spark.
"We need to find some way to value the person for who they are in that moment," she said.
It might be that music is a touchstone that still resonates.
Sometimes, there are surprising revelations from Alzheimer's patients as they lose their filters. Someone who had been reluctant to express love might now find it easier.
"They may take and pat your hand and say 'you are so good to me,'" when that was out of their comfort zone before," Chase said.
Try to stay in the moment with the Alzheimer's person, she said.
"Try hard to see them for who they really are," she said.