The Christmas season encourages us to shift our attention from receiving to giving, and that is a blessing because it frees us for a time from the prison of ego. Today’s financial uncertainty, however, curtails the kind of giving that involves spending money, so people need to seek other kinds.
One special form of giving is visiting a friend or relative afflicted with Alzheimer’s or one of the hundred other forms of dementia. Such people fill the nation’s assisted living facilities and nursing homes.
My wife is in such a facility and for over four years I have had the opportunity to observe both the loneliness of individuals who have few visitors and the joy of those who have many.
Almost everyone agrees that visiting these relatives and friends is a good idea. Many even elevate the idea to the level of serious intention. Unfortunately, all too often the intention remains unfulfilled.
They may remind themselves from time to time, “I’ve got to see Aunt Sarah. I just have to make time. Maybe Tuesday afternoon. Or perhaps Saturday morning. Well, next week at the latest.” But before they know it months and years go by, until an obituary notice rudely informs them that the opportunity has been lost.
A busy schedule is not the only reason people miss such opportunities. Others include a variety of unnecessary apprehensions. Here are the most common ones:
She may not recognize me and I couldn’t bear that. The truth is there are different levels of recognition. She may be unable to say your name or state your relationship to her, yet still feel the warmth of familiarity. And if she does not feel even that—if she “recognizes” only a stranger who is treating her with kindness—that will be no less a blessing to her. The first lesson thoughtful caregivers learn is that the visit is not about them, their feelings, what they can and cannot “bear.” It is about brightening their loved one’s day.
I don’t know what to say or do when I visit. Seeing someone you know in decline can make you feel awkward and uncertain how to behave. But in reality there are many things to say and do that quickly dispel the awkwardness. Here are a dozen simple ones:
Show her pictures of her family and friends. Don’t worry about whether she will remember them. There is a good chance she won’t, at least not in an obvious way, so identify them for her. “This is your son Sammy. He sometimes needed scolding, but you always combined it with a big hug.” “And here is Rose. She has kept all your recipes and now is sharing them with her daughters.”
Explain to her what her friends and family are doing now. Be prudent about mentioning death, but don’t be afraid to mention people’s ailments. It’s OK to say that Uncle Arthur had knee problems and is now in a wheel chair.
Remind her of things she liked to do—for example, ride horseback, dance, or play piano. Tell her of specific occasions when you remember her doing them.
Talk about things you used to do together. Not just big important things, but little ones such as watching a TV show you both enjoyed. If it’s clear she doesn’t recall them, don’t be discouraged. The reason you will be recounting the stories is precisely because her memory of them has faded.
Read to her. If she always kept up on current events, read newspaper articles. If her attention span is short, as it will probably be, read children’s books. Any collection of the shorter Dr. Seuss stories is a good choice.
If she was religious, read some Bible passages she is likely to find meaningful and uplifting. Also, recall her favorite prayers and recite them for her.
Find out the kind of music she liked best. Then get CDs of her favorite singers performing that music, invest in an inexpensive CD player, and play them for her. If you have an ITunes collection, get an inexpensive IPod dock and play your songs for her.
Do simple exercises, such as gently moving her arms and legs and massaging her feet. If she is slumped in the chair with her neck in an awkward position—a common result of sitting in a geriatric chair for some time (or falling asleep on a plane)—help her sit upright and gently stroke the back of her neck. Also consider applying a mild liniment such as Aspercreme to her neck. (Of course, it is always best to get a nurse’s approval for exercises and medications.)
Get a medium size ball—for example, a Nerf ball—and play catch with her, if she is able.
Play a card game or a board game, if she is able and interested. Or do some simple crafts together.
Perform basic grooming for her—for example, brush her hair, apply moisturizing cream, and file and color her fingernails.
While doing all these activities, pause frequently to give her a hug and a kiss and tell her you love her.
I’m afraid she may not respond to anything I say or do. Responsiveness is more difficult to detect as her condition advances. For example, she will have less control over the muscles that control smiling. But the more you visit, the more you will learn to detect small responses—a meaningful glance, a tear, a nod—that the occasional visitor would miss.
Even if you detect no such responses, that does not mean your visits lack value. A mental hospital chaplain once visited a comatose patient daily for months, talking, reading, and praying aloud. In all that time, the man stared straight ahead and never even blinked. The chaplain told me he had begun to wonder if he should suspend his visits. Then one day, the man emerged from the coma and said, “Thank you, Father, for all your visits. Your conversations were my lifeline, even though it was impossible for me to let you know.”
I have witnessed similar, though less dramatic, events with advanced Alzheimer’s patients. For example, meaningful comments from people thought to have lost the ability to understand and respond. Such events remind us our loved one experiences more mental activity than we realize, at least enough for her to sense our expressions of kindness.
I don’t think I’ll be able to resist crying. There is no need to hide sorrow over a loved one’s condition. If you need to cry, by all means do so openly, and let your loved one know why you are crying. For example, say “I am crying because I love you so much.” But don’t let tears dominate. Keep the emphasis on positive emotions, such as the enjoyment of remembering times past and the pleasure of sharing the present moment.
This special kind of giving needn’t be confined to the Christmas season. It is appropriate at any time of the year. And it will not only brighten the life of the person you visit—it will bring you a measure of fulfillment money cannot buy.
Copyright © 2013 by Vincent Ryan Ruggiero. All rights reserved
