And Fred Sings to Ginger, “You Say Tomato, I Say Tomahto”

Recently, a very hot day in New Rochelle combined with just a few appointments, gave me the opportunity to read some of the articles that had piled up on my desk. One piece was from the New York Times Science section. It was about nostalgia (“What is Nostalgia Good For…?” John Tierney, July 8, 2013).  An interesting article, but not eliciting any wows, just some confusion. Readers are given the opportunity to comment on what they have read. And so I posed the following question: “What is the difference between nostalgia and reminiscence?”  Two people responded to my inquiry. Truth be told, I don’t think there is a significant difference.  Kinda like Ginger Rogers and Fred Astaire battling it out in: “You say tomato and I say tomato.”

Despite my inability to truly grasp these differences, I read some of the comments made by other readers. Call it life review, reminiscence or nostalgia, I was  particularly impressed  by the comment of RitaLouise from Bellingham, Washington.

“I am 85. Yes, I do relive parts of the past. But what I really find fascinating is the ‘thread’ of one connection to another in my life. So much has to do with being in the right place at the right time, connecting with a person with a connection that will change your life. To review the successes and the failures simply gives a rich tapestry of life as it is. One decision is pivotal to an outcome that can be a path to progress, or a setback. What is also interesting is when you weigh the balance. Would you change anything? Or are you just content to watch the flow of your life, the possibilities, the decisions, and the outcomes? Life is ‘some and some’, and if toward the end we can be at peace with it, so be it.”

Thank you RitaLouise from Bellingham, Washington.  I have turned your comments into questions as I help clients reminisce about their life tapestries. For this geriatric care manager, a piece of that thread was knotted  more than 25 years ago in the driveway of my New Rochelle home. A friend, just before saying good-bye, made a parting suggestion. Why not consider entering the brave new world of geriatric care management? A suggestion first ignored, then revisited and finally acted upon. Call this musing of a very long time ago nostalgia or reminiscence, it was truly the right decision.

Alzheimer’s Disease: Logic to the Wind and Anchor The Words

As a geriatric care manager, when I consult with  families whose spouse or parent has dementia, one of my first suggestions is to rid themselves of  the following words and notions : “logic, logical, logically even logicalizing.”  Simply stated, dementia is an illogical illness.

A quick example of logic gone awry.  Recently a son was telling me that his father was stepping into the waterless bath tub to shave. He would  not accept assistance and there were no grab bars on the tub walls. “I am going to tell him  it is not safe to do this,” he said to me.  To which I replied, “that approach is not going to work.”  A rather risky response, especially to a new client. I countered with a suggestion of putting some black or red tape across the floor of the tub with a note written in bold stating that the boards beneath the tub are loose and he should not step in. Okay, it’s an untruth, but “fiblets” are one of the most useful strategies in confronting Alzheimer’s disease.

While the above example is one of strategy, there are some guidelines for general communication with someone with Alzheimer’s Disease. By incorporating the six principles below and throwing logic to the wind, I believe a foundation can be established for maintaining or bettering one’s interaction with someone with dementia:

1. Speak slowly and calmly. People with dementia pick up on emotion. If you are upset or frustrated by the situation at hand, your parent will mirror you anxiety.  Pick a better time to have the conversation.

2. One sentence, one thought.  Keep your conversations simple.

3. Make eye contact. As senses become compromised, one needs to focus on the person. Eye contact in a quiet room without distractions will aid in effective communication.

4. If you are asking a question, ask just one question at a time.

5. Evaluate whether physical contact; holding a person’s hand, an arm around a shoulder, a hug or a kiss on the cheek will help or hinder a conversation.  Use this approach accordingly.  

Finally, the use of a “half smile.”  It is a just that, a semi-smile, take a look at Mona Lisa, she has the idea. It can reduce the stress of the caregiver and sets the stage for successful communication. As a geriatric care manager who often models herself after the Mona Lisa, or at least her smile, I invite you to learn more about the half-smile: