Author: Dr. Christine L Williams

Over 5 million people have Alzheimer’s disease in the US and 15.4 million are family caregivers, mostly spouses. Communication is vital to maintaining an intimate relationship with a spouse and is linked to marital satisfaction and better mental health. Language problems such as finding the right word, repeating the same word or question over and over, and substituting one word for another are common in Alzheimer’s disease. As a result, couples begin to suffer isolation, depression, and estrangement. Dr. Christine L Williams is an expert on the unique relationship between persons with dementia and their caregiver spouses. She has developed an intervention to improve mutual understanding, and thereby strengthen marital relationships. She has published numerous articles describing her research results supporting the value of her intervention Communicating about emotions and relationships (CARE). Dr. Williams has expertise in both quantitative and qualitative research methods including instrument development. Caregivers may be well-meaning but can still frustrate their spouses with the wrong approach. For example, a caregiver may choose to go over a family photo album and ask the afflicted spouse if he or she remembers the family vacation in Wyoming in 2005. When the person with dementia cannot remember, both parties end up feeling terrible. Clearly, that’s not an effective communication strategy. Dr. Williams calls this “disabling conversation.” A different approach is what this intervention study is all about. Step by step, communication can increase without increasing tension and unhappiness. Tips for communicating with your spouse with Alzheimer's disease 1. Share news of the day Share news about family and friends and the daily agenda so that your family member with memory loss is still involved in everyday life. 2. Expectant waiting Set aside a small amount of time when you are not busy and distracted - just to talk. Focus on being open to whatever your family member considers important. You don’t need to keep talking. It’s OK to sit quietly together and let your family member break the silence. 3. Connect Communicating is more than talking or exchanging information. You can communicate without words. What is your voice saying? Does it show compassion, impatience, love, or disrespect? Are you communicating what you intend? Is the message one of caring? 4. Search for ways to communicate Try multiple ways of engaging. Try a new topic, a touch, a smile, or a song. 5. Accept their story Listen without correcting. Honor your family member’s efforts to communicate even if you disagree with “the facts”. Being “right” is not as important as being supportive. 6. Share memories Couples share special memories. Rather than ask, “Do you remember the time…” Share the memory freely. Offer memories of special times. Think of it as a gift. Start with “I remember when…” 7. Tell stories Tell a story about shared interests, what you are reading, what you noticed about people, events, or nature. These are everyday stories that can help you stay engaged with your family member. 8. Create a caring environment By creating predictability and a supportive environment, you are making it possible for your family member to take the risk to join into conversations. Being corrected or ignored is painful and can encourage a someone with a memory problem to give up trying. 9. Give compassionate care When a family member with a memory problem needs help, provide it with compassion. Use words and gestures to express your affection as you offer help. While love may have been taken for granted before, it needs to be openly expressed now. 10. Delight in unexpected responses There will be moments of clarity, shared humor, or times when your family member will let you know that you are appreciated. Feelings are beyond words. Appreciate and cherish those special moments.