Lori Nisson

Lori Nisson, director of Family & Community Services for the Banner Alzheimer’s Institute and Banner Sun Health Research Institute, reviews some basic communication principles.

When is it OK to lie to someone you love?

As Lori Nisson, director of Family & Community Services for the Banner Alzheimer’s Institute, explained at an event presented by Smile on Seniors last week, sometimes caregivers have to tell white lies — what she dubbed “therapeutic fibbing” — in order to avoid arguments with patients suffering from dementia.

This was just one of the pieces of advice Nisson dispensed at the event “Understanding Dementia & Communication.” Nisson, who is also a licensed social worker, said the event was one of a number she and her organization conduct to help patient caregivers cope with the stress and challenges of caring for someone with dementia.

“This is a class on communication,” Nisson explained. “Alzheimer’s and other forms of dementia are brain diseases that can affect people’s ability to communicate and understand language. It’s really important for family caregivers to shift the way they communicate with somebody with dementia.”

Nisson said Alzheimer’s disease affects 5.5 million people throughout the United States, representing the lion’s share of all dementia cases — approximately 70 percent. She said this number is expected to increase dramatically over the next few years as the U.S. population continues to age.

The stress and cost to care providers is often extreme, which is one of the reasons Nisson said classes like this one are so vital.

“Our goal is to end Alzheimer’s disease before it affects another generation,” Nisson said. “In the meantime, my department seeks to provide education, support and outreach for people living with memory loss, and a lot of the work that we do is surrounding the support and education of family caregivers.”

Nisson offered a range of advice for caregivers, mostly focusing on ways to reduce conflict by improving caregivers’ communication skills. Several times, she said, “You can never win a battle with someone with dementia.” Nisson said it was best to avoid hot-button issues or correcting people when they make inaccurate statements because it causes both the patients and caregivers unnecessary stress.

“If someone is in a lecture or congregation or a business and they are fumbling around or they are talking out of turn, instead of feeling annoyed or frustrated with them, recognize that this may be a symptom of dementia,” Nisson said.

Although there is currently no cure for Alzheimer’s, Nisson noted there have been some advances in treatment, including drugs that can help slow the disease’s progression. Early detection is critical in these cases. Emotional and physical withdrawal are often a patient’s initial responses to dementia.

As the condition advances, the job of caregivers can become more challenging. In some advanced cases, Nisson said patients can begin to lose their language ability. She cited as an example a woman who had immigrated from Italy who lost her ability to speak English and reverted to speaking Italian.

Janice Freibaum, one of the event’s attendees, said she is dealing with a similar problem with her own father, who is a Holocaust survivor and sometimes reverts to speaking Yiddish. Freibaum recently moved her father to Arizona from Florida, a change that has been difficult.

Nisson said changes in environments can often trigger patients.

“There are so many potential triggers for Holocaust survivors,” Freibaum said. “If they’re in a care facility and someone says they’re taking them to the showers, think about it. For many Holocaust survivors in the throes of dementia, as the disease progresses they revisit that time constantly and it’s torturous.”

Ron Carmichael, whose wife has dementia, said he found the event highly informative.

“My wife was diagnosed in 2010,” Carmichael said. “I’ve been walking the journey for these eight years, and in the process, I’ve learned that certain things are helpful, particularly support items for caregivers. The caregiver has a journey, too. Part of that journey is learning how to deal with the thing and having access to opportunities like Banner’s presentation today, or the Duet [Partners in Health & Aging] program, which are both excellent opportunities to learn how to cope and have hope.”

The event was held at the Chabad-Lubavitch Center in Phoenix. Smile on Seniors, in partnership with Duet, began a free 10-week, peer-led discussion for family caregivers. To sign up, call 602-492-7670 or email chani@sosaz.org. JN

For more information on Banner Alzheimer’s Institute and some of its upcoming training events, visit banneralz.org/education-events.