The art of conversation

For issues specific to caring for someone with dementia.
Image I know what dementia's like Iris. Jill has vascular dementia after TIA's in April 2006. Some days she's OK and others she cant remember how to do the simplest of things. I've even had to learn how to do her make up for her, which is very sad as she used to be a beautician for Elizabeth Arden!! All she wants to do these days is to watch TV and wants me to do the same! It drives me mad. She seems to be jealous of my computer as it takes me away from her. She likes me sat next to her all the time Image Even if I have it on my lap, she gets fed up of it. Its very trying to say the least.

Pete
Frandrake, you live in a beautiful part of the country. We have stayed near Lake Vrynwy several times, and I love all the driving round Shropshire and Powys.

It is a tough job to care for someone with dementia, especially when you love them so much. Our small hospital used to bring people in for respite care a couple of times a year to give their family a rest. Some of the nurses used to take them out for a run in their cars,(wouldn't be allowed now I don't expect),and they were able to go back to their family more relaxed than if they had just sat in a chair for a week. (We had more time and energy than family carers to be able to give them these outings).
Hello Iris.

I'm so sorry to hear about your plight with your husband. I only joined this forum a few days ago, but the help & friendlyness I've encountered has amazed me.

My wife, pauline, has alzheimers & vascular dementia in the moderate to severe stage. She was only diagnosed last march & has got so much worse very quickly.
One of the problems is that she can't talk, or at least just one or two words rarely. It's not that she doesn't want to, it's that she physicaly can't say the words, so it's easier for her not to try.

It is difficult trying to communicate with someone who can't give you an answer. I have to be very carefull how I phrase the question. If it's a closed question, she'll just agree or disagree by nodding or shaking her head. If I ask it in such a way that she has got to decide herself what to say, then she says nothing, because it's too much information for her to deal with.
So I'm as bad scalded as burnt.

I ask her questions & talk to her a lot, I don't get anything back but that doesn't matter. Then I look closely at her facial expressions & body language & work out from those what she wants or needs. I can do this because I've known pauline since she was 13 years old & know her very very well. I don't allways get it right.

Unfortunatlly Iris, there's no easy answer I can give you for the communication problems your encountering with your husband. The only thing I can suggest is, don't try too hard to get an answer from him, that can have the opposite affect. just talk as you would normally, he mite just respond, my wife surprises me sometimes & gives me a full sentence, allbeit with difficulty, but she does.

Remember Iris, we'er all in a similar boat & there's lots of support for you on here.

many regards Ken.




My OH seems to have gone in to another stage now. He just doesn't speak to me or the family, sits staring out of the window and accepts food and drink. His morning helper manages to get a word here or there and the evening one tries hard but often gets no response.

This is even worse than his loss of memory, we can't get him to go out of the flat and if we mention it he almost becomes hysterical.

Just wondered if anyone else has experienced this as I am really trying to communicate but having no success.

Iris
dear imp

dont know if this is relevant to your situation but here goes...my mum has vascular dementia and my mum-in-law has frontal lobe dementia...although their dementia has different mechanisms, they both share the symptom you described about your OH...and both showed similar patterns of aggressive, sometimes violent outbursts

My father in law was suddenly taken into hospital leaving her without a carer...i had tried to tell the family for 2 years of my fears about her health but my fears were dismissed...however without her minder she was lost and it quickly became apparent to all that she needed help

After more violent outbursts and several episodes of going AWOL she was sectioned for her own safety and is now in care

One of the Community Psychiatric Nurses tried to explain...in the very early stages the patient is aware they are struggling and will hide or cover up their symptoms...this may be years before anyone else notices....but it means they are already disposed to being secretive....more and more often as the illness progresses they start to forget things as well as ideas...they move something....but because the dementia destroys their short-term memory, they then cant find it...now imagine how many times they are doing this each day...its easy to see why they think "somebody is hiding stuff or stealing their stuff"

The usual solution is to squirrel stuff away and of course they know they hid it but have forgotten where ...so thats proof that someone was watching them hiding it and stole it... they may start to look closer to home for the culprit and blame the spouse , a relative or a carer but the end result is a cycle of unwillingness to talk coupled with anger etc and a deep unwillingness to leave where they feel safe......in my mother-in-laws case...only i noticed....but she carried on pleased that she was keeping up a facade of normality

This gradually worsens until it almost becomes paranoid and delusional..my mum kept saying that bastard stole my fags...my dad had emphysema and they had both given up 20 yrs earlier.....both my mum and mum-in-law would rather die than voluntarily leave their possessions to be stolen....they would literally have to be dragged out...it took 4 police officers to get my mother-in-law to hospital..with her screaming that my wife was trying to get rid of her so she could get her stuff....the house is up 12 stairs and my wife is confined to a wheelchair with MS

Although these delusions continue and can get worse you can still work around it using distraction techniques...eg...i know ...we'll try to find it in a minute...do you want a cup of tea....lets go next door to see ....did you said you want your coat....oh sorry you said you wanted to go to the garden for tea...you must have forgotten ......sometimes it works

its a sair fecht but the rare flashes of them as they were become more precious than gold...hang in there and please keep in touch to let me know how you are coping
[quote]Iris, what about moving his chair to a different place in the room ie. near the window so that he can see out? Maybe move it after OH's gone to bed or he might see you doing it and get agitated about it being moved.

might just need to bite the bullet and ask to move it...to visit my mother-in-law we need to move the bottom of her bed 1 foot to allow access space between her bed and her wardrobe.... to allow her daughter to get in on her wheelchair (my wife has MS)...the request is never taken with good grace....so sometimes we just inch it over gradually....risky if she notices cos she can flip out!...most times i just ask her if she would mind us doing it...quickly followed by..oh dear i inexplicably cant seem to manage...i wonder if you could help...9 times out of 10 she is chuffed to be able to help somebody else and we laugh about how useless i am!
Thanks to you all for your advice. Eddie has been in hospital twice in the last six weeks and in consequence I have not been posting although I have been reading. He first went in to have a supra pubic catheter installed and came back with broken ribs having managed (allegedly!!) climbed over the bed rails. After a few days at home he was unable to walk and s I could not cope with the lifting and transferring him he went back for rehabilitation, unfortunately in a hospital 26 miles away. The whole family has had an exhausting time visiting etc.

Whilst he was away we have recarpeted the sitting room and bought him a new chair so when he came home it was all different but he accepted it so he now sits in a different position.

Thank you again for all your good wishes. Iris
try visiting the Alzheimers society website on www.alzheimers.org.uk for lots of relevant information on types of dementia, symptoms etc

...sorry to hear about the climbing accident and the resultant broken ribs....whilst it does look bad, the sad fact is that unlike you, many hospital staff don't really know what its like to care for someone with dementia....its the hospital way...tests done...check, obs. done ....check....next patient...

....sadly even given the very best hospital and the best staff in the world things are hampered by budgets...no government in the history of the NHS has ever supplied a 24 hour 1 patient/1 staff care ratio......this works when the patients are mentally competent...most patients are compliant and content to wait for treatment etc, but a patient with dementia simply shouldn't be left unsupervised

thus a dementia patient separated from the usual carer is an accident waiting to happen

if all this sounds like im a stooge for the hospital staff...during a recent visit to our house, my own mum fell and gave herself a nasty black eye....all because my brother put her dignity before her safety and let her go to the loo unsupervised

to get further help and respite, get in touch with VOCAL, the carers organization....I can get contact details for you if you wish....and please do keep in touch with all on the forum