Saturday, March 30, 2013

Alzheimer's World -- Nonverbal Communication and the Dimensions of Time


By Bob DeMarco

A few days ago I was watching a short video made by a television station about an Alzheimer's caregiver and her mother.

They shot the video in the home of the family.

Basically, the video showed the older daughter caring for her mother who had Alzheimer's disease.

The video was very well done. I found myself feeling an entire range of emotions as I watched. I was very happy to see that the daughter was very caring. I was also saddened as I watched and saw the feelings of sadness and frustration on the face of the daughter from time to time. Alzheimer's does that. It brings out feelings and emotions sometimes in waves.

There was one scene where the daughter wanted the mother to get up out of her chair and go to bed. The mother shook her head no, and when prompted to get up said NO. NO World.

The daughter then reached down and tried to grab her mother by the arm and pull her up. This was not in any mean, or rough way. The mother recoiled and pulled her arm away.

This reminded me that sudden movements really don't work well with my mother. Also, getting into a situation where she is digging in her heals on something is not a good thing.

You don't want to bring out the "hardheadedness" in someone with Alzheimer's. This leads to the hard NO. The NO -- where the Alzheimer's patients shows you "who is the boss".

I learned that nonverbal communication often works best with someone who has Alzheimer's disease.

Here is the way I approach similar situations.

I'll say to my mother time to get up. Often she says NO, I don't want to. I say "its time." Rule number one here, less words are better when delivering a follow-up to the word NO.

Always try and use the fewest words possible. Not "you need to get up", or "you know blah blah blah", or "if you don't blah blah blah". Skip the blah blah blah. Its too much information and can make you seem "bossy".

I say "its time". Then I hold my palm out, palm facing my mother so she can see it. At the same time, I am offering her my hand. That is the position.

If she doesn't look at my palm, I wiggle it a little bit until she looks. No words. Just the palm.

Palm open signifies a few things nonverbally. The obvious -- take my hand. The less obvious but powerful nonverbal communication -- I am receptive to you, I like you. That is right. When a person is talking to you and they open their palms out toward you -- they like you, they are receptive to you.

Point counterpoint. When a person turns their palms out they like you. Lets compare this to when a person folds their arms across their chest, what does this tell you?

It tells you they are not receptive to what you are saying, they don't like what you are saying, and it is making them uptight. The exact opposite of the offering of the palm, the crossed arms mean they are "closing you off".

Back to mom, the open palm, and offer of my hand.

When I offer the palm of my hand and stand there silent and waiting it sometimes seems like I might be standing there for a very long time.

In situations like this, time takes on a different dimension. So standing there for 20 to 30 seconds, holding your palm out might seem like an eternity. If you are not aware of this "time dimension" it is easy to get stressed or to start reacting with your mouth. Persons with Alzheimer's react to stimuli slowly, in this case the offering of the palm.

Alzheimer's World is a slow motion world.

Alzheimer's World

Should it be a surprise that a person with Alzheimer's moves and reacts slowly? I don't think so. Should you allow this slow motion world to turn you "Topsy Turvy" all the time? I don't think so. But I bet it does.

You can't hurry in Alzheimer's World. You have to slow down and learn to take a few deep breaths.

Like I said, Alzheimer's World is a slow motion world and this requires you, the Alzheimer's caregiver, to learn to operate at a new speed and to learn a new kind of patience.

It isn't easy. You have to practice -- over and over and over. Or, you can continue doing the same thing over and over -- go ahead bang your head against the wall.

You can't hurry love by the way. So when you are practicing patience and the offering of the palm just think of it as another way of saying -- I love you.

You choose. Stress, frustration, anger, -- or -- feeling all warm and fuzzy inside when you accomplish your mission.

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Original content Bob DeMarco, the Alzheimer's Reading Room