Interacting with People with Alzheimer’s與阿爾茨海默病患者的相處之道

埃絲特·黑雷曼　王丹丹/譯

Though sometimes challenging， social interaction can be beneficial for someone with Alzheimers disease. But it can also sometimes be triggering， making a tough situation potentially worse for everyone involved.

對于阿爾茨海默病患者而言，社交互動有時雖有難度，但可能很有益處。然而，它有時也會引發強烈的恐懼或擔憂，可能使涉及的每個人本已艱難的處境變得更糟。

Understanding more about Alzheimers and dementia may help explain some of the interactions you may be having with a loved one who has been diagnosed. It can also help guide you as to what not to do or say to someone with Alzheimers， so your encounters can be better for both of you.

了解更多有關阿爾茨海默病和癡呆的知識可以幫助解讀你和確診的所愛之人之間的一些互動，還有助于指導你注意在與該病患者接觸時說話或做事的禁忌，這樣你們會相處得更好。

This article lists six things to avoid when interacting with someone with Alzheimers disease and why doing so can be helpful.

本文列出了與阿爾茨海默病患者相處時要避免的6件事，并解釋了為何這樣做會有幫助。

Dont ignore them

不要忽視他們

If youre not sure how to interact with someone with obvious signs of dementia， its OK to feel awkward. What doesnt help is shutting down and not making an effort to interact.

如果你不知道如何與有明顯癡呆癥狀的人互動，感到尷尬是情理之中的。拒絕溝通和不努力嘗試互動都沒有幫助。

The same applies if you suddenly start cutting back on visits because youre feeling uncomfortable.

如果因感覺不自在而突然開始減少看望次數，同樣于事無補。

According to a 2018 study in the Journal of Biomedical Science， social interaction is vital to people with Alzheimers as it can improve memory loss by increasing synaptic plasticity （the ability of nerve cells to communicate with each other）. By contrast， a lack of social interaction can accelerate memory loss and cognitive decline.

《生物醫學科學雜志》上刊發的一項2018年的研究報告表明，對于阿爾茨海默病患者而言，社交活動至關重要，因為社交可以增強突觸可塑性（神經細胞間相互交流的能力），從而延緩記憶喪失。相反，缺少社交活動則會加速記憶喪失及認知能力的衰退。

Both quality and quantity count when it comes to the social interactions a person with Alzheimers needs. This may not always be easy or without stress， but the more you put in， the more you get out.

對于阿爾茨海默病患者而言，所需社交活動的數量和質量都很重要。這可能并不總是那么輕松，或許還會感到重重壓力，但是你付出越多，得到也越多。

Dont assume theyre confused all the time

不要以為他們一直是糊涂的

Even though someone who has Alzheimers may have episodes where they forget or fail to recognize things， they may still have frequent moments of clarity. This is referred to as transient terminal lucidity.

即便阿爾茨海默病患者可能間歇性出現忘記或者無法辨別事物的狀況，但他們仍常有清醒的時候，這就是所謂短暫的“回光返照”。

While the moments may be fleeting， they can be ones in which memories and communications skills are suddenly intact. This may include memories of interactions you recently had.

盡管這些時刻或許轉瞬即逝，但患者那會兒的記憶和交流能力可能突然變得毫無缺失。其中或許包括近期與你互動的記憶。

Dont assume that you can say whatever you want around them “because they wont remember it anyhow.” In truth， they might.

不要以為“他們什么也記不住”就在他們身旁口無遮攔。事實上，他們可能記住了。

Even if someone with Alzheimers doesnt fully understand what you are saying if you are arguing with someone else in the room， they may respond with upset or sudden outbursts. People with the disease can be extremely sensitive to change in their environment.

如果你在屋子里和另一個人吵架，即便阿爾茨海默病患者無法完全理解你說的話，他們也可能會焦慮不安或者突然情緒爆發。該病患者可能對身邊環境的變化極其敏感。

Dont talk to them like a child

不要把他們當孩子來交談

Just because someone with Alzheimers may need a lot of care doesnt mean you should treat them like a child.

阿爾茨海默病患者可能需要許多照顧，但這并不意味著可以把他們當作孩子對待。

In the end， Alzheimers is a neurodegenerative disease that causes a decline in memory and cognition， the process of acquiring knowledge and understanding through thought， experience， and the senses.

說到底，阿爾茨海默病是一種神經退行性疾病，會導致患者的記憶及認知能力衰退，而認知是通過思想、經驗和感官來獲取知識和理解事物的過程。

Alzheimers doesnt mean that a person is “reverting to childhood” given that children have the ability to grow their cognitive skills. By contrast， people with Alzheimers struggle to retain those skills.

患上阿爾茨海默病并不意味著患者“返老還童”了，因為孩子有能力增長他們的認知技能，相反，阿爾茨海默病患者很難保持這些技能。

People who interact with someone with Alzheimers may knowingly or unknowingly engage in “elderspeak” in which they talk down to that person. This is not only disrespectful， but counterproductive.

與阿爾茨海默病患者互動時，人們總會自覺或不自覺地采取“哄老語”的語氣，以居高臨下的口吻與對方交流。這不僅不尊重人，還會適得其反。

It fails to recognize that interacting intellectually is of greater benefit to someone with Alzheimers than communicating as if to a child.

用這種交流方法的人沒有意識到，對阿爾茨海默病患者而言，理智地交流比像對待孩子一樣和他們說話更有好處。

Dont quiz them

不要考問他們

It is not uncommon for someone to want to quiz someone with Alzheimers to find out how “bad” their condition is or to see if it is worsening.

總有人想測試阿爾茨海默病患者，看看他們的病情有多“糟糕”或者是否在惡化，這并不罕見。

Doing so is not only unhelpful but fails to recognize that the symptoms of Alzheimers can fluctuate. There is rarely a straight line when it comes to the progression of the disease.

這樣做不僅毫無益處，還說明他們沒有意識到阿爾茨海默病患者存在癥狀波動的情況。該病的病情很少呈直線發展。

Avoid asking things like “What is my name？” or “What day is it？” This can cause extreme anxiety， which can lead to agitation， restlessness， and extreme upset.

避免詢問“我叫什么？”或“今天是周幾？”這類問題。這可能會讓患者極度焦慮，進而產生焦躁、不安、極度煩悶等情緒。

Dont focus on what they are unable to do

不要在意他們做不到的事

Watching a loved one in decline can be distressing and make you feel an extreme sense of loss. Acceptance of these changes can be difficult， but holding onto the loss neither helps you nor your loved one with Alzheimers.

看著所愛的人日漸衰弱可能非常痛苦，也會讓你產生強烈的失落感。接受這些變化或許十分艱難，但若對這種失落耿耿于懷，不論是對你還是對患上阿爾茨海默病的親人都沒有任何幫助。

Rather than focusing on what they can no longer do， focus on the things they can and engage with them on that level. This may involve playing games or pursuing activities they can manage， like walking， playing puzzles， dressing up， or combing their hair.

與其在意他們已經沒法做到的事，不如關注他們能做的并在此層面與之交流。或許是玩游戲，或許是參與他們能應付的活動，比如散步、玩拼圖、穿衣、梳頭。

It is important to remember that the Alzheimers journey is not the same for all people. While memory loss is common， certain long-term memories may be retained. Similarly， some facets of cognition may be preserved， including the ability to recognize and respond to stimuli like touch or smell that offer your loved one comfort or pleasure.

有一點非常重要，需要牢記：阿爾茨海默病的病程人各不同。盡管記憶喪失很常見，但某些長期記憶可能會保留下來。同理，某些認知方面的功能或許也被保留下來，包括識別和回應觸覺、嗅覺等外界刺激的能力，這些刺激會給你愛的人帶來安慰或快樂。

Dont assume they choose to be difficult

不要以為他們在故意刁難

In the later stages of the disease， people with Alzheimers will sometimes lash out for no obvious reason. This can manifest with screaming， cursing， insults， pushing， hitting， and throwing things. As much as the attacks may seem directed at you， theyre usually not.

在病程后期，阿爾茨海默病患者有時會無緣無故大發脾氣。這可能表現為尖叫、咒罵、侮辱他人、推搡、打人和扔東西。這些攻擊看似是針對你，但通常不是。

No one can really say why these outbursts occur， but it is thought that they represent frustrations or fears that cannot be communicated in a rational or cohesive way.

沒人能真正解釋為何會有這樣的情緒爆發，但一般認為，這代表患者感到不安或者害怕，他們無法以理性或連貫的方式進行溝通。

The causes are many and may include：

情緒爆發的原因有很多，可能包括：

The inability to articulate physical or emotional pain

無法明確表達生理或者心理上的痛苦；

Changes in the environment that cause confusion

環境變化帶來的困惑；

Feelings of isolation or that you are being ignored

感覺受到孤立或忽視；

Feelings that they are not being understood

感覺自己不被理解；

The loss of control and being forced to do what you dont want to do

失去控制且被迫做不想做的事；

Not being able to make sense of whats going on around you

無法理解周圍發生的事。

Rather than taking the attacks personally， it is best to step back and try to identify the triggers that set off the outburst. By doing so， you may be better able to avoid future outbursts and， in turn， improve the quality of life of your loved one.

與其認為這些攻擊是針對你個人的，不如退后一步，嘗試找出患者情緒爆發的誘因。這樣才可能更有效地避免未來再次爆發，從而提升所愛之人的生活質量。

（譯者為“《英語世界》杯”翻譯大賽獲獎者）