Tips to be a more proactive, interactive grandson in the context of Alzheimer's

May 9, 2011 6:47 AM

Interactions with a grandparent suffering from Alzheimer's---suggestions and ideas for activities? (more inside!)

I'll be flying home in a few days to visit family and friends for the first time in a year. I went home last year during a very difficult transitional time for my extended family when my grandfather's alzheimer's suddenly became increasingly burdensome for himself and those carrying for him. I found myself pretty unprepared regarding how I could interact with my grandfather whenever I visited him. He is understandably and often disoriented and cannot hear anymore (and is for the most part confined to a wheelchair). Sometimes I write to him on a computer and show him photos, but I found this approach too distant.

I have great respect for him, and although we weren't very close due to the fact I mostly lived abroad, as a kid, I was always excited when he would fly over and visit us and was always enthralled with his war stories and other memories. My father mentioned to him that I would be returning soon and said that he seemed very excited about this prospect.

This time around I'd like to be there more when he's awake and try to interact with him more, but I'm not really sure how to start. Any ideas? Thanks in advance!

posted by wallawallasweet to Human Relations (11 answers total)

My wife used to volunteer for Hospice and liked working with dementia patients. More than once, she's said that what made the difference wass that she didn't bring a load of expectations about what the person was supposed to say or be like, because she didn't have a long history with them. Family members are typically much more aware of what is being lost (war stories, etc.) instead of what is there now. So I suspect that you and he will both have a better time if you can set your expectations aside.
posted by jon1270 at 6:57 AM on May 9, 2011

My mother works in a hospital unit with many cognitively impaired patients. They recently created carts that each have a theme and contain objects that are centered around that theme. For example, there is an animal cart, which has nature documentaries, stuffed animals, animal puzzles, etc. A baseball cart has old trading cards, a dvd of classic games, a catchers mitt, etc. You could perhaps think of a theme he would enjoy and bring a few objects around this theme.

Another favorite activity among the patients are dvds of old tv shows such as I Love Lucy. The dvds will have subtitles you could turn on if his vision is okay.

If he has some motor skills and long term memory, he may be able to play a simple game (like tic-tac-toe) or do an activity (like a puzzle) with you.
posted by halseyaa at 7:01 AM on May 9, 2011

My father had Alzheimer's, and even in his late stages loved doing puzzles. I brought out some easy kids puzzles, and if I dumped them on the table, he would want to come right after and start doing them. Sometimes that lasted for only about 5 minutes and then he would get tired of it and put them away and we could just dump out the same puzzle again later.

I also tried getting him to paint, like water colors, and he did that for a bit, maybe 5 or 10 minutes. I think the main thing was just be patient and if he gets bored or tired, just let it go.

He also enjoyed some movies, like Marley and Me and Up, but not others like Cars. He enjoyed certain songs, like You are My Sunshine. I'm not sure what stage your grandfather is at, but I really think just being smiling and happy to see him is one of the best things you can do.

I know I did buy a bunch of books about Alzheimer's Activities, so maybe check your library before you head off, but I can't think of anyone that stands out for being helpful right now.
posted by katinka-katinka at 7:20 AM on May 9, 2011

My mom is succumbing to dementia. All I can advise is that you simply arrive with no expectations. Your interactions with your grandfather will probably not be satisfying for yourself. In fact, they may be terribly demoralizing for you. You will need to keep a brave face and simply go-along with wherever the conversation turns. Even if you find yourself treading-down the same, distorted path over and over and over again.

It can be an exhausting experience, and highly frustrating. At some point, you will probably find yourself on the verge of exploding at your grandfather. Please fight that urge. He doesn't understand what he's doing/saying. In my mom's case, she has a vicious combination of hallucinations and paranoia that combine to create these crazy stories that she repeats ad infinitum. You have to just grin and bear it.

Above all, keep in-mind the Ten Absolutes for dealing with an Alzheimer's sufferer:

• Never Argue, Instead Agree
• Never Reason, Instead Divert!
• Never Shame, Instead Distract!
• Never Lecture, Instead Reassure!
• Never Say "Remember?" Instead Reminisce!
• Never Say, "I told you..." Instead Repeat and Regroup!
• Never say,"You can't!" Instead Find Out What They Can Do!
• Never Command or Demand, Instead Ask and Model!
• Never Condescend, Instead Encourage and Praise!
• Never Force, Instead Reinforce!

Some are harder than others to follow. In the case of my mom, she sometimes hits me with situations/comments that simply cannot be responded to without creating division or argument.

Best of luck to you. I'm sorry about your grandfather.
posted by Thorzdad at 7:29 AM on May 9, 2011

Patients who can no longer communicate verbally can often sing just fine, provided it's a well-known song (e.g., the Happy Birthday song). It's amazing to see someone who hasn't spoken a clear word in years sing lyrics without difficulty. If he was a regular church-goer, perhaps there are hymns he might know and enjoy singing.
posted by dephlogisticated at 7:38 AM on May 9, 2011

Definitely agreeing on the music front. Again, go in with no expectations, but talk to your family members about music he may enjoy. If they don't know specific songs or artists, bring a few varied examples of some stuff from when he was younger -- I'm guessing big band music, standards, etc. Standards are good because they're usually pretty simple (compared to, say, jazz) and easy to sing along with/remember.

My mom and her sisters would sing along with the piano player at my grandma's nursing home ("When the Red, Red Robin Goes Bob, Bob, Bobbin' Along..."). Sometimes my grandma would sing along, too, but on other occasions she would get huffy and say, "Girls! You are being SO rude to that nice man who is here to play for us!" Given her roles as both a nurse and mother of nine children, that brought her back to the place she was most accustomed.
posted by Madamina at 8:15 AM on May 9, 2011

One of my fondest memories of visiting my grandmother while she was in mental decline was when my brother and I were both visiting her from our far-away homes/lives, and he directed the conversation so well. If your grandfather's not hearing well enough to converse with, this may not help, but I'll throw it out here anyway. It usually worked well when there were two people visiting at once so that she could listen and participate a bit without having to direct the conversation.

She was very excited that we were there, but kept looping through the same pleased questions:
It's so nice to see you, how long has it been? Are you staying with your mother? So how long are you here? How's school? (note, I was no longer in school) It's nice to have you back, how long has it been? Are you staying with your mother? etc.
After a couple of loops, my brother picked up the ball beautifully, and would just answer those questions every few minutes while we talked. He'd make sure to remind her what was going on (we were her grandchildren visiting our mother for one week which we hadn't been able to do since Christmas), while making forays into more vivid conversation - the kinds of things she's love to know if she only remembered to ask us about, for example, why isn't my brother's wife visiting? (but she's not going to ask because she's probably only 50% sure that he's married.)

A: So, E, it's been 6 months since we were both home for Christmas. I know mom's really glad we're staying with her this week, and it's great to see Granny again. Tell me about your job in Chicago.
E: That's right, I've been out of college for 3 years, and this is the first time I've had a job doing physics. I really like living in Chicago. Did I tell you about my apartment? I have the quilt Granny gave me on my bed. It's great to be home visiting you Granny, we get to stay a whole week!
G: Oh, I'm so happy you're here. Are you staying with your mother?
E: that's right, we're staying at Mom's house down the road. We haven't been home since Christmas. Say, A, how's J? You guys have been married 2 years already, right?
A: Oh, she's great, J and I love our house in Atlanta. Yes, J and I got married 2 years ago in August. Have I told you Granny, how happy we were that you were able to come to our wedding? It was really hot that day, it's a good thing we had that red striped tent. (she had laughed about the red circus stripes, well, isn't that nice, weddings are supposed to be a party) But my wife J can't be here today. We're staying with Mom all week, and J wasn't free to leave Atlanta for that long.

and so forth, looping back to mention those key phrases (staying at Mom's, visiting for a week, calling each other by name, mentioning where we live, happy to see her again) as often as possible.
posted by aimedwander at 8:55 AM on May 9, 2011

My grandfather had dementia, and towards the end of his life, when he'd forgotten pretty much everything and everybody, he still loved to listen to music and sing. I played my violin for him, we sang old hymns (he remembered every single word, despite have no ability to talk otherwise), we sang folk-songs, we listened to old folk dancing records that he used to dance to...

My grandfather also LOVED dessert right up until his last few days. Hanging out in the kitchen and baking cookies was pretty great.
posted by Cygnet at 9:10 AM on May 9, 2011

Bring some old photo albums IIRC some Alzheimer's patients have great long term memory. If he doesn't respond to them then you can guide him through the photos and perhaps spark an old memory or story.
posted by Gungho at 9:31 AM on May 9, 2011

Hey, thanks for the suggestions thus far!

Thorzdad's insights are really principles I've seen my father and uncles following since my grandfather has become ever more confused and is prone to episodes of extreme insecurity and paranoia---often lashing out at them for the frustrations that have come with increased immobility, physical discomfort and the result of spending most parts of the day trying to be asleep. He's most hard on the people he is closest to (his sons) and tends to give a much wider latitude to other members of the family/women and outsiders.

As my grandfather seldom speaks and cannot hear (and doesn't want to wear any hearing aides), I will stick to being present for him, bring his favorite snacks and find photos I've taken with him in the past. We used to write on slips of paper to communicate (he would write back and sometimes even correct grammatical errors---these days he tends to read and nod a response without writing back), maybe I'll stick to this as well. Puzzles and games sound like a great idea too, I'll give it a try when I return.
posted by wallawallasweet at 1:21 PM on May 9, 2011

Walla Walla, if your grandfather is not very verbal anymore and can't hear, I wonder if stimulating his other senses might help? You could bring different kinds of fabric for him to touch (maybe you could ask him to help you pick which fabric you'll make a dress or shirt from?), or make cookies so that he can roll the dough in his hands, or tell him you're going to finger paint and ask if he would like to join you.

Stuff like the fingerpaint can seem childish if you present it as, "It's fingerpainting time, Grandpa! Do you want the RED paint or the BLUE paint?" I roll up to my grandmother more, "Yo, Grandma, I'm gonna fingerpaint since I can't draw to save my life. Wanna join me?" She'll usually go along, I think initially to make me happy, then because, you know, it is pretty fun.
posted by Snarl Furillo at 1:48 PM on May 9, 2011