1, 2, 3.

4

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“Hm, hmm, oh, wow,” Carol* said, touching some of the puzzle pieces on the table. She picked one up and turned it around in her hands, staring at it with a faint smile. “Well, yes, this is really…this is really something,” she mused.

Carol is in a later stage of Alzheimer’s disease. She loves to touch things, communicates using sounds and short sentences, and she’s pretty mobile. It’s very challenging to get Carol to follow instructions such as, “Come with me,” or, “Let’s stand up/sit down.” She’ll smile and acknowledge you, but she’ll have trouble understanding what you’re asking her to do.

I’ve recently stumbled upon a new way to get my residents in this late stage to come with me. Say you’re trying to get Carol to go to the bathroom with you. She’s sitting down and you’re trying to motion for her to get up. She’s not understanding what you’re asking her to do.

Instead of getting frustrated, count to 3—out loud.

“Let’s get up on the count of three,” you say. “One, two, three,” and assist her in standing up.

I’ve tried this with a few different residents, and it always works. Why? “On the count of three” is a phrase most of us learned as kids. My mom would always instruct us to do things “on three." Recall that people with dementia still have a lot of their long-term and procedural memories. When you just say, "Come with me” or “Let’s go,” these phrases don’t signal an action. “One, two, three,” signals that something will happen on “three.”

Give it a try and let me know if you found it effective.

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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