Q. Some of my friends and acquaintances are having memory problems. Most are suffering from Alzheimer’s disease. In keeping up my relationship with them, how can I most effectively communicate given their limitations?
Let’s begin by talking about Alzheimer’s Disease. So, what is it? According to the National Institute on Aging, it is “a brain disorder that slowly destroys memory and thinking skills, and eventually, the ability to carry out the simplest tasks.” It most often affects older adults, so age is a risk factor. More than seven million Americans are living with the disease, according to the Alzheimer’s Association 2025 report. With the increase of our older population, that number will only grow. It is the seventh leading cause of death.
Now to your question. I had a recent conversation with a 15-year-old whom we’ll call Sally. Her perspective might be helpful.
Sally has a loving relationship with her 88-year-old grandmother, whom she describes as frail and remembers nothing from the present and lots from the past. She notes that her grandmother easily gets confused and may even forget to eat. She cannot be left alone since she tends to wander and is prone to falling. Her grandmother has a full-time care provider and has been diagnosed with Alzheimer’s disease.
My question to Sally was: “How do you make this relationship work?” She told me her story, filled with experiences, philosophy and advice.
Addressing the memory problem. Sally video chats with her grandmother regularly in addition to visits, which might be a few hours or the better part of the day. She said, “If I didn’t see her so much, she wouldn’t remember me.” And added, “Of course, she always recognizes me and seems to forget the bad things.” For example, her grandmother recently had hip surgery and doesn’t remember her physical limitations, trying to do things that may lead to a fall. In helping her, Sally feels like she needs to be her grandmother’s second brain, but adds, “It’s important to never make that person feel like they need a second brain.”
The conversation. Sally said she typically initiates the conversation as she would with anyone, asking, “How are you”? “What have you been up to?” What typically follows is a question about something her grandmother loves, such as her favorite horse at her family farm or her current constant dog companion. Sally noted that she never runs out of questions because her grandmother doesn’t remember the questions asked. So, Sally may repeat the same question to her grandmother, not sequentially but intermittently. Asking the same question with the same answer is just fine with Sally.
Feeling normal. “I treat my grandmother as if she didn’t have the disease. I want her to feel normal, even if it’s just for a minute,” she said. It was important to Sally that her grandmother not feel invisible. She said, “Even with the repeated same answers, it’s important to be attentive and interested.” And adds, “Act as though you heard what that other person is saying for the first time.” Additionally, Sally suggests that others should always direct questions to the person with the disease rather than to someone who may be accompanying the individual.
Advice from Sally
- Don’t assume those with the disease are no longer aware. They need to be included.
- Don’t make them feel invisible.
- Don’t take things personally if the person doesn’t remember you. What is important is that you are with them.
- Even though they may not remember you, you are making a difference.
- Money and gifts don’t matter; family and friends do.
- Know the brain can register when you are happy. If you are not treated well, you can easily become sad and depressed.
- Be clear and simplify. Instead of saying Tom’s nephew is visiting, say our cousin Gary Smith will be visiting. Say the name of the person.
- You can set a standard. When others observe you, they can get the message, and there will be a chain effect.
I asked Sally for keywords that we need to remember in relation to a loved one with Alzheimer’s disease. Here they are – “patience, inclusion, positivity, acknowledgement, encouragement, caring and love.” Finally, I asked, “Do you feel you are making a difference?”
“Of course, I am,” she said.
Here are some additional tips from the Alzheimer’s Association: Ask yes or no questions. For example, ask, “Would you like some coffee?” rather than “What would you like to drink?” Avoid criticizing, arguing or correcting and maintain eye contact to show you care about what that person is saying. For more communication tips, see the National Institute on Aging.
I told Sally that with her insight, compassion, empathy and problem-solving ability, she will be successful in whatever she chooses to do with her life…and others will benefit.
Stay well, everyone, and know small acts of kindness matter.
Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com. Visit Helen at HelenMdennis.com and follow her on facebook.com/SuccessfulAgingCommunity