The Ten Absolutes

Absolute Nine: Never Condescend, Instead Encourage and Praise!

Over twenty years ago, I worked with a lady in her home one day a week, for ten hours. She was what we refer to as a person with early-onset Alzheimer's disease. This means she had been diagnosed when she was under the age of 65. In her case, she was 49 when she was diagnosed and was about 55 when I met her. She lived with her three adult daughters who had hired me to care for her on Saturdays so they could have time to do the things necessary to live their lives.

Each Saturday I went, one or more of the daughters and I would visit for about a half an hour. They would tell me about their Mom and what had happened that week, and what she needed that day. We would also share happenings in our lives and talk about the daughters' plans for the day. We were about the same age and became friends, so there was a lot of talking and laughing.

Well, their mom had lost the ability to verbally communicate. She liked to walk a lot, and while we were talking she would walk in and out of the room. When her daughters would leave, it seemed as if she felt her job for the day was to convince me that I should never come back again - and she was really good at her job! She was very good at getting me to go out in the yard and then locking me out (I learned the first Saturday to keep a key in my pocket). If I was foolish enough to let her get too close to me, she would push, and had been known to hit. It took me a long time to realize that the reason she disliked me so much was that we all sat and talked when I arrived, and we didn't include her. I realized this one Saturday, and called ahead to suggest that we have her sit at the table with us and include her in the conversation. It was like magic! When the girls would leave, we could continue the conversation as much as we could. I would just move nearer to her, and engage her with some of the things I knew she liked. That way, we developed a relationship and enjoyed our time together.

Absolute #9 says, Never Condescend, Instead Encourage/Praise. It is very common for caregivers, especially when someone has lost some or all of their language skills, to assume they cannot communicate. Thus, the natural inclination is to talk about them in front of them as if they are not even there! The person who is providing the instructions for care of the patient needs to make certain they are on the same side and at the same level as the person for whom they are caring. Clearly, the two of them can then pass on any necessary information to the other person together.