alzheimer's disease

The Best Friend Approach to Alzheimer’s

When I began to understand the reality of caring for my mother, who has an Alzheimer’s dementia, I was, like everyone else, unsure and filled with questions about how to ‘be’ with her. I was very uncomfortable when she endlessly repeated stories, or mixed up the characters in them. And when the memory of my father began to fade, to be replaced by childhood memories, I was shocked, disoriented, and greatly saddened.

I felt guilty about feeling bored, inadequate in the extreme (where was my wise, earthy, intuitive mother to help me figure this out?). But mostly I had questions: Do I gently correct her, bring her back to the here and now, as one of my sister’s opined? Would this strengthen her grip on “reality”, stimulate her mind and delay her decline? My instinct was let it go, to go along with wherever her story was leading her, but perhaps this was a disservice, perhaps she needed me to anchor her in this world?

I can’t say I ever really got answers that satisfied me, so I was left to follow my intuition – which I have only just found confirmed in The Best Friends Approach to Eldercare, by Virginia Bell and David Troxel. These compassionate authors have worked for many years with long term care of people with Alzheimer’s. The idea behind their approach is that what parents – or other elders – need most is simply a best friend, someone who is understanding, positive, and reassuring. Someone who doesn’t judge them, correct them, tell them what to do or how to think or behave.

In discovering this so-called method, I’ve felt very validated. I realize that I became conflicted when I looked at my mother through the lens of a disease. But when I saw her simply as my mom, I took her as I found her, and extended to her the same simple human kindness I would to any friend. I don’t lecture, correct or try to ‘improve’ her, my job is to connect with her, and to meet and support her where she is.

Here are a few of the basic principles behind the Best Friend’s approach.

Go With the Flow – Caring for your parent is about making them happy, safe, and comfortable. If your father says, “I’m eating breakfast now,’ it might be tempting to note that it’s dinnertime in the hopes of making him less confused, but it’s not as helpful as simply saying, “Yum, it smells good.” Just go with the flow and enter their world.

Let Go of Perfectionism
– Choose activities your parent will enjoy and don’t worry whether they’re done correctly. If s/he can’t follow the rules of a card game anymore, try sorting the cards into suits and colors. If s/he likes helping around the house, give him or her a concrete task to do, like folding laundry. It doesn’t matter if it’s done perfectly. What matters is that your parent is having fun and feels useful.

Above All Else, Show Respect – Remember that yours is an adult relationship that consists of adult activities and communication. Even if your parent has Alzheimer’s, there’s no need to play games meant for kids or to speak as if they’re children. Foster their dignity above all else.

About the Author:

Kathleen Daniel, MS, L.Ac. writes about change and transition from the inside out, combining insights and experience from her lifelong yoga practice with her work as an acupuncturist, organizational consultant, educator, and life and leadership coach. An alumnus of Johns Hopkins Women’s Leadership program, she also leads active retreats for reflection and renewal for women. Website:
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Psych Talk

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