Interacting with someone who has Alzheimer's and depression
September 13, 2013 1:42 PM   Subscribe

I'm visiting my grandfather for the weekend at his nursing home and I'm frequently at a loss for what to say and do with him. He's always been a quiet, stoic guy, but compounding that is the fact that he has Alzheimer's, major depression, and he lost his wife (my grandmother) six weeks ago. If I ask him what he'd like to do or where he'd want to go, he has no idea.

I've heard that you should talk to old people about the past, and he does remember things from long ago, but it's mostly painful stuff he doesn't want to talk about. Any times I remember spending with him as a child also brings up thoughts of his wife, which is painful for both of us. I talk about my life now, but he just kind of nods and I'm not sure he understands. He has no memory of my husband.

He's mobile enough to walk for short periods, but he has diabetes and needs various medications that I can't give him, so we can't go too far. He's also incontinent and doesn't seem to realize when he needs to go or when he has had an accident. If he falls, I can't pick him up.

He's able to read, but when I asked him if he'd like me to get him some books he said no. He refused games or movies as well (he has a TV but doesn't watch it). The nursing home had live music today and he didn't want to go to that. He's not religious and doesn't want to go to church (neither do I, but I would if he wanted to). I offered to get him anything he wanted from the store and he said he couldn't think of anything. When he was younger and healthy, his interests were working on cars, home repairs, travel (in an RV!) and watching college football. He's not interested in the football anymore and he can't do the rest.

So... I have no idea how to fill four days, besides taking him out to eat a few times (the only thing he definitely loves for sure is hot dogs). He obviously loves having me here, and he cries when I leave even for a few hours (which is totally heartbreaking). How can I make the best of this?

(We're in Little Rock, AR if you have any specific local suggestions. I'm willing to drive wherever but not I'm sure he's up to it.)
posted by desjardins to Human Relations (24 answers total) 4 users marked this as a favorite
What about playing some CDs or records of music that was popular when he was young?
posted by telegraph at 1:51 PM on September 13, 2013 [1 favorite]

Can you ask him for advice about any home repairs or car problems you may be dealing with? Or that you may pretend to be dealing with? Giving advice might help him to feel useful and involved in your life, or at minimum start a conversation.

Even if he says he doesn't want books, do you think he might read them if you brought some and left them with him? Maybe non-fiction related to his interests--college football history? RV culture? travel narratives? Maybe biographies of some of his contemporaries?

Does he enjoy any card games?
posted by snorkmaiden at 1:52 PM on September 13, 2013 [3 favorites]

Can you bring a simple activity you can do together, like a jigsaw puzzle?

Or a project ostensibly for someone else? Like, we're working on a _____ to send to cousin Sue?

Asking for advice is a great idea - maybe ask for help in planning some of your future travels - where did he go in his RV that you could re-visit?
posted by LobsterMitten at 1:56 PM on September 13, 2013

Might he enjoy it if you read to him?
posted by insectosaurus at 1:58 PM on September 13, 2013

Music is HUGE. Play stuff from his era, or talk to him about music, or do anything related to music. It can literally stimulate his brain so he remembers and becomes more lucid.

If you can sing along with him (or dance, or anything), it's great.
posted by Madamina at 2:00 PM on September 13, 2013

Rather than ask, which can be agitating, make suggestions.

"Let's play Gin-Rummy."

"I brought this music for us to listen to."

"I have these movies I think we'll enjoy together."

Sometimes being asked to decide something or to come up with an idea can be really frustrating for someone with Alzheimer's.

The fewer decisions the better.

If he flat out says he's not interested though, move onto something else.
posted by Ruthless Bunny at 2:00 PM on September 13, 2013 [14 favorites]

Old radio shows? Did he listen to The Shadow when he was younger?
posted by Dynex at 2:04 PM on September 13, 2013

I remember him listening to country music when *I* was younger - George Jones, Merle Haggard and that kind of thing. Maybe young Elvis, too. I don't have a CD player but I could make a spotify list.
posted by desjardins at 2:10 PM on September 13, 2013 [1 favorite]

Great suggestions above, but also don't discount the value of just sitting quietly with him.

I know that sitting quietly makes many of us anxious, especially in this era of being online all the time, but when you get to a certain age, it's just a pleasure to see and sit with someone, rather than feel that you've got to *do something* to fill the space.

If you sit quietly, you can just make comment on things you see - if you're outside, it can be a flower, a noisy car, whatever. If inside it can be just innocuous about the people around you. It doesn't have to be INTERESTING or anything like that. Just quiet times, sitting with your grandpa, building memories for the future.

If it's really really hard for you to sit quietly, feel free to bring some kind of activity that you can do that's visible to him. Knitting, playing soliataire (real cards, no screens), drawing. Probably not reading to yourself - it should be some kind of activity that he can watch you do and comment on, if he likes.
posted by jasper411 at 2:13 PM on September 13, 2013 [8 favorites]

You might invent a project you need help with -- like, if you can take him to a public garden, you might have a plant identification book and tell him you need to find a pink rose. As you go through the garden, keep saying, "I need to find that pink rose. Do you see any?" You could do something similar with birds or trees. Or if he's strong enough to go to a shop -- "I need to find white thread. Do you see any white?"

Don't offer him options. Say, "I need help." If he can't actually help, he can still be present while you "work" on your project.
posted by BlahLaLa at 2:15 PM on September 13, 2013

My dad is in end stages of Alzheimer's and has had a stroke, so communication is very difficult. Pre- stroke, he became far enough along that having any meaningful conversation was not really possible. I found that all I could really do was to have a one sided conversation with him, ie. me telling him about things I was doing, interested in etc. Basically almost a monologue. I suspect a lot of that did not resonate either. Bottom line- its very hard, and exhausting too. We watched DVDs of a reality show about flying planes in Alaska- two things he enjoyed. Those were good because there was not really any plot to follow- just planes flyin'. If he's like my dad, you may find you can come and go (when you need a break) and it will not impact him greatly. Other things: showing pictures, music if enjoyed, walks (even short). My dad found it very difficult to make decisions or to discuss the past. I'd avoid asking lots of questions etc. I'm sure it's different for everyone but I hope this helps.
posted by ecorrocio at 2:21 PM on September 13, 2013 [1 favorite]

The Alzheimer's Association has suggestions for activities and other resources for family and friends of people with Alzheimer's or dementia. It might be helpful to poke around there.
posted by jaguar at 2:22 PM on September 13, 2013 [1 favorite]

Minor League baseball game?
posted by bq at 2:23 PM on September 13, 2013

With my mom, games and puzzles are a source of frustration, as is any activity that she was once proficient in, but now cannot connect the dots. Each case is different, but you might have the same result with those activities. Mom likes to go for rides, and out to eat. Talking about long past times can work also. I have found that correcting her "mistakes" can cause frustration too, so I just let it slide most of the time.
Good Luck !
posted by lobstah at 2:25 PM on September 13, 2013

I second the idea of card or board games and puzzles, the more collaborative and less reliant on memory, the better. My grandma likes jigsaws and crosswords, but even just playing solitaire as a team can be fun.

I also second the idea of music (and dancing, if he's up to it). He'd also probably appreciate hearing some music that you like and that you want to share with him, even if he finds it less dance-able than something older. Music relieves a lot of the pressure to keep conversation going while keeping the mood upbeat, so it's great to put on if you're both running out of steam at any point.

If his attention span is shot, either by memory problems or depression, movies might be a little tough -- but a self-contained TV episode of an engaging show might be enjoyable and low-stress for both of you. My grandma likes British detective shows, but maybe he'd like an episode of that sports doc show ESPN does (there are a bunch of episodes on Netflix streaming). It also gives you something interesting to talk about over a meal later.

Also think about bringing a handicraft to work on while you and your grandpa watch TV or listen to music. My grandma has always loved knitting and needlework, and even though she can no longer do it easily, she likes when I bring over a project to work on. That way, she can still be involved in picking out the yarn and pattern and watching me work, but there's no pressure for her to try to tackle her own project or really keep track of anything. I think she also likes seeing her grandchild engaging in something she's always loved. If your grandpa was always handy and mechanical, maybe he'd enjoy seeing you tinker at something while you guys are hanging out, or watch you rig up or fix something in his room?

Along with that, your grandpa will probably love seeing you do things like cook or clean or do chores for him, or otherwise take care of the kind of tasks that probably matter a lot to him but which are now difficult for him to do for himself. If he drinks coffee, for example, just firing up an electric kettle and brewing some for him in a french press, and sitting there drinking it together in his room, can feel very homey and reassuring for you both. Don't underestimate the emotional power of just puttering around :).

If he is no longer able to get out much, maybe a short drive would be fun? Not necessarily *to* anywhere, or just for something very short like a trip through a drive-thru to pick up milkshakes -- basically just a fifteen minute spin around town to get a change of scenery. Also, it might give you a sense of perspective and control to drive around in the wider world for even a short stretch. Being around someone with mental and physical health issues can make a person feel trapped and powerless very fast, and it might be good to get a breather.

Most of all, try to concentrate on activities that you can carry on alone or that don't put him on the spot -- he probably tires out much earlier than he wants you to leave, so there may be many times throughout the visit when he desperately wants the activity to continue, but no longer has the mental or physical energy to really engage in it himself.
posted by rue72 at 2:45 PM on September 13, 2013 [2 favorites]

How about watching YouTube videos of his favorite country artists together?
posted by Wordwoman at 3:05 PM on September 13, 2013

"Talking about the past" doesn't have to involve super-personal painful memories.

You can ask him questions about what the world was like when he was younger -- research some specific things to ask about based on his age and personal experiences. Avoid anything that has some obvious painful memory attached to it. Check out some of those lists of "if you were born in x, you remember..." for ideas.

Even if his past from early childhood on literally WAS full of painful memories, you might find some bright spots in there to get him talking about like TV or radio shows. If he had a really bad home life, ask about what sort of things they learned in school then. If there's a time in his life he has liked to tell stories about, in a part of the past he still remembers, get him talking about that -- it doesn't matter if you've heard the story many times, you are asking him to tell it so you can enjoy hearing him tell it now.
posted by yohko at 3:09 PM on September 13, 2013

Also, if there's things he doesn't remember that you wish he would, like you having a husband, get comfortable with the idea that trying harder to get him to remember this won't help.
posted by yohko at 3:12 PM on September 13, 2013

What about bringing a map, and showing him some possible routes that you're planning in your RV? Even if he doesn't offer much advice, you could highlight the route, point out some possible stops, and think about nice side-trips.

Did he visit national parks? Maybe bring a book of photos and maps from some of the parks and talk about what you'd like to see.

Another activity you can do while chit-chatting -- coloring books. It sounds insane, but it's actually very cathartic and there are some great adult/sophisticated books now. If you came in with some nicely sharpened colored pencils, and some of these books, and just started coloring, he might be into it too. Maybe say you're sending them to Aunt Tilda or just that you've picked it up. Here are a few specific suggestions based on his interests, but if you search around Amazon you'll find a tons of nice ones. My grandma likes the ones with flowers, gardens, houses, mandalas and stained glass windows.

- Classic Cars of the Fifties Coloring Book
- American Muscle Cars, 1960-1975
- Airplanes of the Second World War Coloring Book
- Famous Trains Coloring Book
- Exploration of North America Coloring Book
- Historic American Landmarks Coloring Book

Another thing would be working on little models of cars, but he might not have the dexterity or eyesight for it.
posted by barnone at 3:28 PM on September 13, 2013 [1 favorite]

Oh, and this series of Word Search puzzles is awesome. There are a few books in the series and they are much better than other versions for a few reasons:
- spiral binding allows the book to lay flat while working on the puzzles, and he can keep the page open to the one he's working on. So much better than a paperback that closes when you put the book down, causing you to have to search for your active puzzle the next time you pick it up.
- large text -- better for aging eyesight
- difficulty isn't too hard or too easy
posted by barnone at 3:31 PM on September 13, 2013

How about reading to him, or reading to each other? (Assuming he can still read.) Does he have a favorite author? If not, is there a book you can think of that's about a subject he's interested in? Reading together is a good way to bond, and getting caught up in a story can really help you get away from your troubles for a while. Short stories might be particularly good, so he doesn't lose the thread. Or maybe a very famous, frequently adapted novel, so he won't miss too much if he gets foggy for a bit. And if they're stories he knows from reading them a long time ago, they might access a part of his memory that the (goddamned) Alzheimer's hasn't ravaged.
posted by Ursula Hitler at 4:22 PM on September 13, 2013

My father has dementia, so I've been there. Music, my voice, me taking the initiative are all things that have worked for us.

But there's one other thing that has made an even bigger difference, something I always had trouble with when I was younger: physical contact. I've never hugged and held my dad so much as I have since he went into long-term care. I find it's the one thing I can give him that really soothes him and makes him happy. When it comes down to it, we don't stop being kids. Touch makes him feel loved and safe, something I can sense, even though he has difficulty speaking.

It can be as simple as holding hands.
posted by rhombus at 5:40 PM on September 13, 2013 [5 favorites]

Some suggestions on at and music activities for ppl with Alzheimers. Also, did he play an instrument when he was young? If so see if you can get him an instrument to play.
posted by bunderful at 5:15 AM on September 14, 2013

What about geo caching? Outdoors - physical, but not strenuous - requires looking for small boxes and solving puzzles, hence a sense of accomplishment, but low pressure.
posted by bq at 3:43 PM on September 14, 2013

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