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By: Sherry Katz, LCSW 
No disease brings much good news with it; the combination of medical management, life style changes, possible economic and daily functioning routines that are affected by prioritizing optimal health for as long as possible, are time consuming and life altering foci. Unique to Alzheimer’s disease is that in addition to the above description, it presents the challenge that basic communication, judgment, decision making, memory, planning and expressiveness each will gradually diminish. These losses very soon become problematic for anyone wanting a sensible conversation with the patient, and most especially so for those who have regular contact, emotional involvement, and responsibilities toward this patient. If the patient’s abilities to interact have changed, then it follows that those who elect to communicate or maintain their relationship with the patient, must also change their habits of relating to the person.
There are certain dynamics of human relationships that remain constant through most of the disease process for most patients, despite the loss of cognitive functions such as logic, sensible speech, properly identifying objects and knowing their use; executive function, such as planning, organizing and utilizing information; and interest in self-care, such as routine hygiene, nutrition and hydration. These foundational dynamics are trust, respect, empathy and support. In my 28 years of clinical practice working with Alzheimer’s disease patients and their families, I have always found that when family members express, respond, and act from these outlooks within themselves, relationships are happier and stress decreases.
“Trust” in terms of relating to an Alzheimer’s patient means much the same as it does to the rest of us; having this disease does not make us less human, it makes us less functional. If a patient learns over time, that the caregiver is sincerely interested, thoughtful and consistent, then the patient will develop trust. The patient most likely has simpler terms of trust than a non-patient; s/he may begin trusting if hygiene routines are handled gently, or that the caregiver/family member reliably brings them a blanket.
“Respect” toward a patient is also identical to what it means for the rest of us non-patients; a sense that the person in front of us deserves our non-critical attention, goes a long way for anyone. Many times, patients become more cooperative with routines they have long forgotten the purpose for, because of the respect they are receiving.
“Empathy” means interacting with a patient with an understanding that having less and less of a mind, has got to be difficult. Again, declining functionality does not deserve or indicate less need or capacity for human relationship dynamics. A patient can offer empathy and will do as much as possible when receiving it.
Alzheimer’s disease patients can smile for many years and many cognitive losses into their illness. While their concrete needs will always increase across the board, in the areas of custodial, financial, household, safety, and medical needs, there is a common human bond we share with Alzheimer’s patients, that offers steady and rich opportunities for enjoyable, certainly less tense, relating. About the Author...
Sherry Katz, LCSW practices family therapy in Ridgewood, NJ. She specializes in decreasing stress and increasing harmony in any type of relationship situation a patient wants to improve. Her patient population includes couples and families.
Ms. Katz can be reached directly: 201.445.4770 www.newviewsfamilytherapy.com
Click here to contact or learn more about Sherry Katz Last Update: 8/3/2008
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