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Published April 13, 2013, 11:35 PM

Minding Our Elders: Speak respectfully to cognitively impaired parent

DEAR CAROL: My sister, Ann, teaches nursery school several hundred miles away from our home town where I still live. Our mom has dementia and is in a nursing home here. I’m happy to visit Mom often and take care of her needs. Ann handles Mom’s finances, so she is also contributing to mom’s care. We get along well in general, but her occasional visits create tension.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: My sister, Ann, teaches nursery school several hundred miles away from our home town where I still live. Our mom has dementia and is in a nursing home here. I’m happy to visit Mom often and take care of her needs. Ann handles Mom’s finances, so she is also contributing to mom’s care. We get along well in general, but her occasional visits create tension. Ann means well, but she’ll sit with Mom and me in the room, and just talk to me, ignoring Mom. Ann says she’s uncomfortable sitting alone with Mom, since Mom’s dementia makes her hard to talk to. When she does talk to Mom, she addresses her like a 3-year-old child. I don’t want to insult my sister so I haven’t said anything, but I feel bad for Mom. What do I do? Randy

DEAR RANDY: I’m sure your sister doesn’t mean any disrespect. She simply isn’t used to being around people with dementia. Her mother has changed and your sister only sees her occasionally, so the gaps in time make her Mom’s decline seem more shocking. This not only makes Ann uncomfortable, but likely intensifies her grief over the changes she sees.

As difficult as you may find this, the only way you can change how Ann relates to your mom is to discuss things. First tell her that you know she loves her mom and doesn’t mean any disrespect toward her, but that you feel she is ignoring Mom and that she may feel shunned.

Ann’s approach likely makes her feel as though she’s visiting her mom, but also “accomplishing something,” which is talking to you about financial and other shared issues. One way around this is to make sure Ann has time alone with Mom after you’ve talked with her about interacting more appropriately.

Your other concern with how Ann addresses your mom is also valid. She realizes that your mom has trouble understanding what is said or even what is happening around her, so she unintentionally diminishes your mom by slipping into her nursery school mode. Her professional persona probably kicks in when Mom doesn’t understand or respond to her words, so she simplifies what she’s saying, perhaps even changing her tone of voice. Simplifying sentences is not only okay, but sometimes a positive way to communicate with someone who has dementia. However, she still needs to keep her tone of voice respectful and address her mom as an adult. Also, just sitting quietly and holding Mom’s hand or gently touching her will add a lot to the quality of the visit.

If you are careful and compassionate, there’s hope that Ann will be able to understand how you interpret the way she’s coming across to her mom. It may help if you can tell her some stories of when you’ve fallen short when caring for your mom so you don’t sound like you think you’re an automatic expert. You can let her know you’ve learned through trial and error, and continue to do so as your mom’s condition changes.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.

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