Interacting with People with Alzheimer’s与阿尔茨海默病患者的相处之道

埃丝特·黑雷曼　王丹丹/译

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.

对于阿尔茨海默病患者而言，社交互动有时虽有难度，但可能很有益处。然而，它有时也会引发强烈的恐惧或担忧，可能使涉及的每个人本已艰难的处境变得更糟。

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.

了解更多有关阿尔茨海默病和痴呆的知识可以帮助解读你和确诊的所爱之人之间的一些互动，还有助于指导你注意在与该病患者接触时说话或做事的禁忌，这样你们会相处得更好。

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

本文列出了与阿尔茨海默病患者相处时要避免的6件事，并解释了为何这样做会有帮助。

Dont ignore them

不要忽视他们

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.

如果你不知道如何与有明显痴呆症状的人互动，感到尴尬是情理之中的。拒绝沟通和不努力尝试互动都没有帮助。

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

如果因感觉不自在而突然开始减少看望次数，同样于事无补。

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.

《生物醫学科学杂志》上刊发的一项2018年的研究报告表明，对于阿尔茨海默病患者而言，社交活动至关重要，因为社交可以增强突触可塑性（神经细胞间相互交流的能力），从而延缓记忆丧失。相反，缺少社交活动则会加速记忆丧失及认知能力的衰退。

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.

对于阿尔茨海默病患者而言，所需社交活动的数量和质量都很重要。这可能并不总是那么轻松，或许还会感到重重压力，但是你付出越多，得到也越多。

Dont assume theyre confused all the time

不要以为他们一直是糊涂的

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.

即便阿尔茨海默病患者可能间歇性出现忘记或者无法辨别事物的状况，但他们仍常有清醒的时候，这就是所谓短暂的“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.

尽管这些时刻或许转瞬即逝，但患者那会儿的记忆和交流能力可能突然变得毫无缺失。其中或许包括近期与你互动的记忆。

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

不要以为“他们什么也记不住”就在他们身旁口无遮拦。事实上，他们可能记住了。

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个人吵架，即便阿尔茨海默病患者无法完全理解你说的话，他们也可能会焦虑不安或者突然情绪爆发。该病患者可能对身边环境的变化极其敏感。

Dont talk to them like a child

不要把他们当孩子来交谈

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

阿尔茨海默病患者可能需要许多照顾，但这并不意味着可以把他们当作孩子对待。

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.

说到底，阿尔茨海默病是一种神经退行性疾病，会导致患者的记忆及认知能力衰退，而认知是通过思想、经验和感官来获取知识和理解事物的过程。

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着患者“返老还童”了，因为孩子有能力增长他们的认知技能，相反，阿尔茨海默病患者很难保持这些技能。

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.

与阿尔茨海默病患者互动时，人们总会自觉或不自觉地采取“哄老语”的语气，以居高临下的口吻与对方交流。这不仅不尊重人，还会适得其反。

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

用这种交流方法的人没有意识到，对阿尔茨海默病患者而言，理智地交流比像对待孩子一样和他们说话更有好处。

Dont quiz them

不要考问他们

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.

总有人想测试阿尔茨海默病患者，看看他们的病情有多“糟糕”或者是否在恶化，这并不罕见。

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.

这样做不仅毫无益处，还说明他们没有意识到阿尔茨海默病患者存在症状波动的情况。该病的病情很少呈直线发展。

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.

避免询问“我叫什么？”或“今天是周几？”这类问题。这可能会让患者极度焦虑，进而产生焦躁、不安、极度烦闷等情绪。

Dont focus on what they are unable to do

不要在意他们做不到的事

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.

看着所爱的人日渐衰弱可能非常痛苦，也会让你产生强烈的失落感。接受这些变化或许十分艰难，但若对这种失落耿耿于怀，不论是对你还是对患上阿尔茨海默病的亲人都没有任何帮助。

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.

与其在意他们已经没法做到的事，不如关注他们能做的并在此层面与之交流。或许是玩游戏，或许是参与他们能应付的活动，比如散步、玩拼图、穿衣、梳头。

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.

有一点非常重要，需要牢记：阿尔茨海默病的病程人各不同。尽管记忆丧失很常见，但某些长期记忆可能会保留下来。同理，某些认知方面的功能或许也被保留下来，包括识别和回应触觉、嗅觉等外界刺激的能力，这些刺激会给你爱的人带来安慰或快乐。

Dont assume they choose to be difficult

不要以为他们在故意刁难

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，阿尔茨海默病患者有时会无缘无故大发脾气。这可能表现为尖叫、咒骂、侮辱他人、推搡、打人和扔东西。这些攻击看似是针对你，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.

没人能真正解释为何会有这样的情绪爆发，但一般认为，这代表患者感到不安或者害怕，他们无法以理性或连贯的方式进行沟通。

The causes are many and may include：

情绪爆发的原因有很多，可能包括：

The inability to articulate physical or emotional pain

无法明确表达生理或者心理上的痛苦；

Changes in the environment that cause confusion

环境变化带来的困惑；

Feelings of isolation or that you are being ignored

感觉受到孤立或忽视；

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

无法理解周围发生的事。

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.

与其认为这些攻击是针对你个人的，不如退后一步，尝试找出患者情绪爆发的诱因。这样才可能更有效地避免未来再次爆发，从而提升所爱之人的生活质量。

（译者为“《英语世界》杯”翻译大赛获奖者）