Conversation Tips For Alzheimer’s Caregivers

Conversation Tips For Alzheimer’s Caregivers

Posted on September 16, 2014 by ElderCare Resources in Alzheimers Care, Blog, Caregiver Education, Caregiving, Dementia Care

Alzheimer’s caregiving: Stay ‘in the moment’

By Lee Nyberg

We were talking about visiting the aquarium, and suddenly my dad said, ‘You can’t make a shirt from an American flag.’

People with Alzheimer’s disease, the most common form of dementia, often take conversational “U-turns” like this. Improvisational Theater audiences frequently witness similar twists of plot. As odd as this may sound, taking a closer look at the overlap of caregiving and Improv Theater can help Alzheimer’s caregivers increase positivity and flexibility in their caregiving.

Saturday’s “This American Life,” an NPR radio show, featured a story about caring for people with Alzheimer’s. When the segment’s focus on the similarities of Alzheimer’s care and Improv Theater became clear, I thought I’d heard wrong. I was intrigued by this different way of looking at Alzheimer’s care training, created by Karen Stobbe, an Improv actor and caregiver for her parents.

Related: The Difference Between Alzheimer’s Disease And Dementia

The dictionary defines improvisation as using whatever is available to create something new. Cooks often improvise when they toss a meal together from the food available. Alzheimer’s caregivers and Improv actors use the same philosophy every day, according to Karen; both need a willingness to observe and go with the flow. She created “In the Moment,” featured on “This American Life,” in 2003 to help others bring a person-centered focus to caregiving. In addition to finding classic Improv exercises a great way to train Alzheimer’s caregivers in the unique approach they need, she also realized the key rules of improvisation are the same as the top Alzheimer’s caregiving guidelines. Here are examples of tips on both lists:

• Join in the other person’s world, wherever that is; agree with their reality

• Demonstrate what you want by modeling and mirroring

• Don’t ask questions, issue kind commands

• Instead of arguing, acknowledge and validate

• Set realistic expectations and problem solve

Related: 5 Tips, How to Get an Alzheimer’s Patient to Shower

While “In the Moment,” has more to it than I can explain here, I wish I had known about this kind of approach for communicating with my own mother. We had a lot of interactions like this:

Mom (fearfully): There’s a man in that white car outside.

Me: No, there isn’t. That’s Chip’s car, and he’s with Dad on the back porch.

Mom (angrily): Liar! I’m going to get Thom [Dad] to handle this. You don’t know anything!

If I had acknowledged and validated, allowed my mother to define the situation and really listened to her, per the Alzheimer’s/Improv rules, we might have had an exchange something like the following.

Mom (fearfully): There’s a man in that white car outside.

Me: Yep. I see him, too. I think he is cooking spaghetti in his car. It’s Spaghetti Day.

Mom (calmer): Spaghetti Day?

Me: You’re right, Spaghetti Day. You like fresh mushrooms on spaghetti. Let’s go look in the refrigerator for mushrooms.

Improvisation takes an unrehearsed path, changing the actors’ focus along the way. Similarly, caregivers use distraction and redirection to help calm an agitated Alzheimer’s patient. Veteran Alzheimer’s caregivers and Improv actors would agree: be a good listener and say “yes” as often as possible.

Related: Caregivers, Laughter Still Best Medicine

Many thanks to:,, and

Lee Nyberg seeks to help families and those living with Alzheimer’s through education and her company, Home Care Assistance.