Midwest Mary

Communication is a key factor in a successful marriage. However, dementia is one of the conditions that can make it nearly impossible for us to carry on a conversation with our spouses. Following is an excerpt from my book, The Alzheimer’s Spouse. Finding the Grace to Keep the Promise that introduces this issue and some suggestions on how to work with it.

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Most of us have a tendency to fix things, to jump in and try to make things right. With Alzheimer’s, we can’t always do that. We can’t correct our spouses’ misunderstanding or convince them they’re wrong. On the other hand, we don’t need to agree with what they are saying either.

What our spouses want is to be heard and understood. Listening without contradicting or judging, no matter how peculiar what they are saying is, will ease their frustration. By looking at them sincerely, listening attentively, and placing a gentle hand on theirs, we can help them to calm down and help restore harmony to the house.

This is the perfect occasion to remember a phrase from the prayer traditionally attributed to St. Francis of Assisi, “Grant that I may not seek so much to be consoled as to console; to be understood as to understand; to be loved as to love.”

What our spouses need most is to be consoled, understood, and loved unconditionally. This is true regardless of the fact that they cannot offer such support in return.

Caring for a loved one with Alzheimer’s requires us to act selflessly. No matter how painful, we must put our own feelings aside. We can deal with our emotions at a later date, perhaps with friends, a counselor, or clergy.

Our own attitude is often reflected in the behavior of our loved one. When we are tense they get tense. If we are agitated, they will increasingly become so too. They pick up on our behavior and reflect it. If we want our spouses to remain calm, we need to model serenity for them.

No matter how hurtful, insensitive, or shocking their behavior may be to us, it’s best to allow them to express themselves freely. They aren’t likely to sense our feelings or understand that they are speaking or acting in a hurtful way. They can be quite detached emotionally. In later stages, even informing them of the death of a close family member will not prompt a reaction of sadness.

Delusions, any firmly held belief in things that are not real, and paranoia are other common symptoms that may appear in the mid-to-late stages of Alzheimer’s disease. Hallucinations, false perceptions of objects or events that are sensory in nature, also may occur. Trying to convince spouses that their worries are unfounded will only agitate them further. They believe something disturbing truly happened, and if we argue they interpret our behavior as insensitivity to their legitimate fears.

Here is when it is best for us to listen closely and say little or nothing in response. When able, we can redirect their attention to something less upsetting. Surprisingly, they may not even remember the moment of terror a few minutes later.

Non-judgmental listening and avoiding arguments that can have no positive result will prompt a new, better, conversation. Although such talks may be one-sided, we can converse with them as long as they have the power to formulate words. They may express themselves with a limited vocabulary or with a heavy dose of incorrect word usage. By listening patiently, we offer them the opportunity to feel safe in expressing themselves to us.

I’m surprised at how often I know what Marshall is trying to tell me even when the words he uses make no sense. Our history together allows me to read between the lines, to understand the emotion behind the jumbled words he is using to express himself. And he takes comfort in knowing I have heard him.

This is particularly important to keep in mind when our spouses are showing signs of distress. They may be very obviously angry, but the source of their anger may not be what they are talking about. Their words often do not align with their actions.

A wife may tell her husband she hates him and is leaving him forever when what she is trying to say is that she doesn’t want to eat her broccoli. She might not even recognize what it is that is upsetting. We have to listen with our hearts if we want to understand them more clearly.

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Excerpt from The Alzheimer’s Spouse. Finding the Grace to Keep the Promise. You may also find helpful Navigating Alzheimer’s. 12 Truths About Caring for Your Loved One, and Inspired Caregiving. Weekly Morale Builders.

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©2025, Mary K. Doyle