Photo by Carlos Porto

There was a recent article in the New York Times highlighting the novel way in which a nursing home in Phoenix, Arizona has been dealing with behavioral issues in those with Alzheimer’s. In a sense, the way a caregiver interacts and the techniques used can help to decrease anxiety and lessen some behavioral issues. It reminded me of a patient I met long ago…

A few years back, I worked at an area hospital on the night shift. Besides waking patients up for every little thing (smile), we would encourage our patients to get some much needed rest. There was one patient who my colleague was assigned to, and she had Alzheimer’s. She was small and not too demanding, but on this particular night, the nurse kept insisting she go to sleep. However, the patient had her own desire, and that was to sew. She would come out of the room into the hallway, grab a sheet or gown, and say she needed to sew. The other nurse would coax her to bed, only to find her out in the hall again, insisting on finishing the dress. As time went on, both the nurse and patient were becoming more and more agitated. I felt the best way to resolve the issue was to let the patient sew.

We got a comfortable chair from her room and a pillowcase, and let her “sew.” Immediately, she became calmer as she worked on the dress. After some time, she became tired and went to bed. I later found out the patient had been a seamstress when she was young. It appeared that the ability for her to do what she had done all her life, even if it did not appear to us to be a whole lot, was enough to make her happy and content. In the end, isn’t this what we want?

Needless to say, I can’t compare what I experienced in a hospital one night is the same as what caregivers must do daily, ‘round the clock. There are different stages that both caregivers and the person with Alzheimer’s experience. However providing a sense of purpose, comfort and safety is beneficial for all.

“Meditation is practiced by millions of people around the world, yet this is the first study to explore its potential in reversing memory loss in people who suffer with cognitive impairment,” notes Dharma Singh Khalsa, founding President and Medical Director of the Alzheimer’s Research and Prevention Foundation. At the VNS CHOICE Adult Day Center, our yoga therapist leads a similar type of meditation with participants at the end of her yoga sessions. Our staff are now eagerly doing it as well! Time will tell if we see positive effects on memory and cognition, but given this new information, our seniors are now motivated to participate even more fully, which is beneficial for stress reduction and mental health.

At our Center, we’re open to trying any interventions that may help people with memory loss. Andrew Newberg, MD, associate professor of radiology at the University of Pennsylvania School of Medicine and a co-author of the study, noted that “It would be extremely useful to have a cost-effective, non-pharmacological approach to slowing memory loss.” (Alzheimer’s Research and Prevention Foundation, Newberg AB et al. Journal of Alzheimer’s Disease 2010 Apr; 20(2)

In a study conducted at the University of Pennsylvania by Andrew Newberg, MD, researchers looked at brain images and cognitive tests for individuals aged 52 to 77 with memory problems.    In the subjects that meditated for 8 weeks, their tests showed improvement in cognition, general memory and attention.    

The type of meditation used in this study is called Kirtan Kriya, which is a “12 minute singing exercise…that involves repetitive finger movements plus singing the sounds Saa Taa Naa Maa” (Alzheimer’s Research and Prevention Foundation, Newberg AB et al. Journal of Alzheimer’s Disease 2010 Apr;20(2).    At our Center, we have a wonderful yoga therapist that comes regularly, and teaches yoga and meditation to our seniors.  For years, she’s been doing this type of exercise and it’s wonderful to know there may be yet another benefit to her classes.   Now, the staff want to do it as much as our seniors!

In our program for people with memory impairment, it is very important to help them strengthen their skills and “exercise” their memory as much as possible. Over the years, we’ve observed that the way caregivers communicate with seniors makes a tremendous difference in their behavior, functioning and ability to learn.

When speaking to someone with memory loss or confusion, there are many techniques caregivers can try to enhance communication. See below for some suggestions from the Alzheimer’s Foundation of America (Communication Techniques Brochure):

Communication Tips for Caregivers

• Speak to the person face-to-face. Do not approach from behind or side – this might be startling and create anxiety.
• Speak slowly and use simple words.
• Speak in a calm tone of voice. Even if they don’t understand what you’re saying, they sense the feeling underneath the words.
• Use non-verbal gestures to help cue people.
• Only ask one question at a time. Rephrase the question if they don’t understand you.
• Speak in simple one-step instructions. When the person has achieved one step, provide positive reinforcement and move onto the next step.

Using these simple techniques, we’ve seen remarkable changes in behavior, mood and functioning.  For more information on memory loss and help for caregivers, check out the link to the Alzheimer’s Foundation of America – www.alzfdn.org