How do I talk with a parent who can't recognize me?

April 12, 2009 11:21 PM

How to talk and 'entertain' my mother (with Alzheimers) when she no longer recognizes me?

Three visits in a row now (weekly) and my mother doesn't recognize me anymore (she's in a dementia care facility). I've been expecting this, but realize that I really don't know how to talk with her anymore.
In the past, even though her memory was not great, we could still chat - she'd ask me (repeatedly) where I was working now, and I'd tell her (repeatedly). I actually enjoyed those times, and I think she did too.
Now, she doesn't know me at all - her vision is very poor (she's had macular degeneration for over 10 years), and her hearing isn't great, so it was hard for her to 'recognize' me at the best of times.
Okay, background over - what/how can I best talk with her, and have my visits bring her some enjoyment? Unlike many folks with this disease, her memory in general is pretty much shot - she can't tell stories about her past, and her word access is worse as the weeks go by; so asking her things is hard on her (it comes out often as word salad).
Thanks for any help or answers you can provide. I'm going to bed now, but will check back in the morning.

posted by dbmcd to health & fitness (16 comments total)

Is there any music that she enjoys listening to? Sharing music can be a powerful thing.
posted by not_on_display at 11:32 PM on April 12 [3 favorites has favorites]

My grandmother was a teacher. She loved hearing me talk about the Shakespeare I had been reading - it was just smiles and nods, but you could really see her light up. Is there something like that from your mom's past that you have access to that you could share with her again?
posted by crazycanuck at 11:37 PM on April 12

I've seen Animal / pet therapy and singing/music bring people with dementia up for a bit.
posted by bottlebrushtree at 11:51 PM on April 12

It may help to start thinking of conversation not just in verbal terms.

Her hearing may not be great but if it is still acute enough to distinguish sound she will probably benefit from hearing music, which has been shown to have a profoundly calming affect on persons with dementia. Try bringing a boombox loaded with her favorite music -- or even just sing to her, songs you know she loves. Any song that might happily recall her past is good to include.

Touch is also a powerful and healing thing and often people in long-term care suffer from a lack of it. Bring lotion and while the music plays gently rub it into her hands using the same rhythm. You can also try gently brushing her hair. Odors are also evocative of the past -- a favorite perfume, the scent of oranges. You're trying to create a pleasant sensory environment. Melissa oil (lemon balm) has been shown to be particularly calming.

Even if she can't understand what you are saying some part of her may remember the sound of your voice so you can also try reading to her. Again, if there are any books you know that she loves, anything evocative of the past, that's a good choice. If she tries to talk and it's word salad just answer in an affirmative, upbeat tone.

Alzheimer's is so generally tragic and one of its particular cruelties is that it can be so hard to tell if your love and companionship are doing any good. But they truly are. You can still communicate so much to your mother without words, and she can do the same. Don't give up. You are doing a truly wonderful and needed thing for your mother. Best to you both.
posted by melissa may at 11:52 PM on April 12 [13 favorites has favorites]

Would she be able to follow a short story? Reading to her could be really nice.
posted by 5_13_23_42_69_666 at 12:39 AM on April 13

My great- grandmother had dementia after several strokes and was very similar to your mother, including the deafness, blindness and word salad. Touch is indeed the best thing you can offer, and most of my conversations with Grandma were about random happenings in my life, or talking through Grandma to a third person, loud enough so Grandma could at least nod and smile. And all the time I'd be talking, I'd be holding both her hands, or touching her shoulder or knee, and emphasising my words by bouncing our hands.

There will be an element of frustration, and I don't think you can do much about that aside from acknowledging it (in a lighthearted way if you can). Grandma would pause to contribute something but get stuck on a word and sit and frown. We'd wait for her to work it out, and if it came out jumbled we'd laugh it off and carry on. There isn't much else you can do.

Incidentally, my Nana is now quite deaf and has been in hospital after a series of falls, and all she asks for when we visit is that we hold her hands and rub her knuckles. She finds it soothing. Her eyesight is poor and we take large, blown-up photos in, laminated so she can hold them up close over and over without them tearing.

Your mother might enjoy things she can feel: stuffed toys, flowers, random knick-knacks with unusual textures. Maybe a pillow or throw for her bed, or an item of clothing that feels a bit different.
posted by tracicle at 1:17 AM on April 13

Nthing music. My MIL doesn't recognize any of her family any more and can't really carry on a conversation (she repeats a handful of nonsensical phrases). But, oddly enough, she remembers bits and pieces of a couple of songs. I've found that it really soothes her if I gently stroke her hair and sing "Put Your Hand in the Hand" or one of the other tunes she seems to recognize to her during our visits.
posted by Oriole Adams at 1:23 AM on April 13

Great question.

Yes, your visits mean something, they are worth their weight in gold.

Agreeing with above about music from her generation, lots of hand holding, lotion and hair brushing. Special knickknacks from her home if possible. Telling family stories. If she says something particularly lucid, follow up on that, but give her lots of time to answer you, so she can make the connections in her brain.

Sometimes, people with Alzheimer's or dementia can become nasty or combative. Never take anything personally.

Ask the staff where she lives if there is anything that they do with her that makes her particularly happy. Sometimes it's something the family least expects, like sticking your tongue out (not a great example, but did work with one of my residents, it was the only thing that made her smile). So, ask. You never know.

Take care of yourself, too, and if you have any to spare, do something nice for the nurses or CNA's , like chocolates or some flavored coffees. Happy staff make happy residents, and staff morale can make the difference sometimes between good days and bad days.

I wish more people could understand how important it is to visit the elderly. They look forward to it so much, and it broke my heart to see some go months or years on end without one visitor.

Hugs of support to you, dbmcd.
posted by Grlnxtdr at 5:30 AM on April 13 [2 favorites has favorites]

Yes, also coming in to say that with my grandfather it was touching, laughing, singing and even dancing.

My grandfather in particular loved to move. At the end he had a strong healthy body but a deteriorated mind. I'd start moving with him and soon his eyes would light up and he'd be laughing and dancing with me. I know it meant a lot to him. As all other means of communication faded away, somehow music was the bond that would not break.
posted by vacapinta at 5:45 AM on April 13

Did your mother like going for car or bus rides before the dementia and vision impairment? If the answer is yes, you might try taking her for a ride and see how she likes it. I take care of my 103 year-old grandmother with dementia and car rides have proven to be her favorite activity. We probably average 4 trips a week that last 3-4 hours each. Always the thrillseeker, grandma loves the mountain roads best.

Myother grandma died last year after a series of strokes had left her with no short term memory and she was legally blind. She didn't like car trips, but loved bus trips around the city.
posted by buggzzee23 at 6:56 AM on April 13

Get cds of music from her youth and teenage years. Read to her, bring in things that smell good, and if she loves animals, see if there are any therapy dogs who could visit.
posted by theora55 at 7:45 AM on April 13

When my Grandma was very ill with dementia, she once grabbed onto an alpaca scarf I had knit for my mom and literally would not let it go. I made her a similar one and she seemed to really like holding and petting it- it reminded me of a little kid with a blanket or other comfort object. Maybe you could get her a really nice soft fuzzy item (cashmere, alpaca, rabbit fur) for her to wear and hold.
posted by genmonster at 8:29 AM on April 13

Thanks to *all* of you for your support and excellent ideas. There were many answers that could have been best - but the one marked is because I realized that the staff is indeed my best ally and friend. I know from them that she sometimes joins in the singalongs they have there. My husband plays guitar, so maybe we could sing a few songs for/with her.
We've been bringing our dog, and she does enjoy that, but tires of it quickly.
Cars are not a good idea - she's in a wheelchair and *very* incontinent - and we found when we last took her out that she was easily disoriented.
I always hold her hand when I visit (and give her hugs) - I'll make sure to do more of that.
Thanks to all of you for helping me realize that there are things I can do.
Even though she doesn't "know" me, when I left yesterday I said "I love you" and she said "I love you too" - so somewhere, she recognized me (voice, smell, something). It meant the world to me to hear that.
posted by dbmcd at 9:13 AM on April 13

Best of luck to you, dbmcd. You have a tough row to hoe, but your efforts now will provide much comfort to someone in dire need . Another thing to keep in mind: Since she doesn't know who you are, there's a very good chance she doesn't know who she is, either and that has to be frightening. I regularly tell grandma her name and life history just to give her a refresher course and that almost always brings lots of comfort.
posted by buggzzee23 at 9:45 AM on April 13

Don't neglect the value of reading aloud to her. It doesn't matter if she follows it or not. In many ways, it's like talking to your pet -- the tone of voice, and the reassurance of your presence is vastly better than being alone. Choose books you want to read. Worst case, she gets your company and you have something to do with yourself other than wonder what to say.
posted by _Skull_ at 3:13 PM on April 13

I just wanted to follow up on this and thank you all again. I've visited her several times since the post, and tried something yesterday that made my visits more understandable (to me anyway). I just chatted with her, and didn't worry about whether she was "following" what I said. I heard a man on NPR say that "...people retain the rhythm of a conversation long after they lose the ability to actually converse. You say something, I say something." So I used that and found that we were able to 'talk' again fairly easily.
I also don't tell her I'm her daughter anymore - there are moments she recognizes me in some way, and there are moments when she doesn't, and I don't want to cause any more anxiety. I still hug her and hold her hand, and tell her I lover her - and that seems to work as well.
This community is really great for this kind of advice - you all rock!
posted by dbmcd at 5:12 PM on May 18 [2 favorites has favorites]