当下不知道怎么办时

1. 先慢下来。降低声音，保持距离，确保安全。
2. 看见感受。可以说：“你看起来有点担心，我在这里。”
3. 检查身体需要。疼痛、厕所、饥饿、口渴、太热太冷、疲劳。
4. 减少刺激。关掉电视，少说一句，一次只做一件事。
5. 给两个简单选择。例如：“现在喝茶，还是过十分钟喝？”
6. 不奏效就停一下。换个人、换时间或换方法，再观察。

依据：沟通口袋卡第 1 页；《日常沟通》第 3-6 页；《认知障碍与反应性行为》第 2-5 页。

“认知障碍”是由影响大脑的疾病引起的一组症状的总称，可能影响记忆、思考、解决问题、语言、情绪和行为。阿尔茨海默病只是其中一种原因；血管性认知障碍、路易体病和额颞叶认知障碍等也可能出现相似或重叠的表现。

可能出现的沟通变化

这些变化不是懒惰、固执或故意不配合。随着语言减少，表情、姿势、动作、声音、行为和触摸会变得更重要。

保护仍然存在的能力

• 每年检查听力和视力；需要时戴好清洁的眼镜和能正常工作的助听器。
• 从她会做、喜欢做的事开始，例如摆餐具、听熟悉的歌、园艺、画画或折毛巾。
• 记住她仍需要陪伴、目的感、归属感和被尊重。
• 观察非语言信号：皱眉、护住身体某处、退缩、来回走动，可能在表达不舒服。

依据：《日常沟通》第 1-5 页；《给认知障碍人士的沟通策略》第 1、3-4 页。

1. 从正面靠近并介绍自己。“妈妈，我是小玲。我来陪你吃午饭。”即使是熟人，也可以温柔地提醒身份和来意。
2. 先得到注意。面对她，保持自然眼神接触，慢慢移动，不从背后突然碰触。
3. 用她喜欢的称呼。语速慢、发音清楚、语气平静；不要用哄小孩或居高临下的口气。
4. 一次一个意思。短句胜过长解释；一个步骤完成后再说下一步。
5. 把开放题变成简单选择。“喝茶还是咖啡？”比“你想喝什么？”更容易回答；也可以用“是/不是”问题。
6. 留出回答时间。问完后安静等待，不急着替她回答，也不要显得不耐烦。
7. 认真听，再核对。如果没听懂，可以重述：“你是说肩膀疼，对吗？”如果她愿意，再帮忙补词。
8. 边说边做。指向门、拿起外套、展示照片或用手势，让动作支持语言。
9. 先回应情绪。“那一定很害怕。”“你很想回家，是吗？”被理解后，事情往往更容易处理。
10. 温柔触碰并观察反应。握手或轻拍有时能安慰人，但突然、粗重或对方不喜欢的触碰会增加压力。

把“纠正”换成“连接”

把环境也变成沟通的一部分

• 关掉电视或收音机，减少同时进行的谈话。
• 一对一或小组交流，通常比大群体更容易。
• 避免需要按字面理解的比喻、讽刺和太快的玩笑。
• 如果双方越来越急，暂停，稍后在更清醒、更安静的时候再试。

依据：沟通口袋卡第 1 页；《日常沟通》第 6 页；《给认知障碍人士的沟通策略》第 2-3 页。

• 告诉家人：“我需要多一点时间找词，请先不要替我说完。”如果你希望别人帮忙补词，也可以明确告诉他们。
• 请对方慢一点、用短句、重复一次；噪音太多时换到安静地方。
• 多人谈话很累时，选择一对一交流。忘了一个想法也没关系，它可能稍后回来。
• 用纸条、日历、手机录音、图片、画画、手势或身体语言帮助表达。
• 累的时候先休息，再谈重要事情。像对待好朋友一样耐心对待自己。
• 尽量保持社交联系；支持小组能让你遇见理解这种经历的人。

看医生前准备一张纸

• 写下自上次就诊以来的新变化、症状、药物和最重要的三个问题。
• 可能时预约较长时间，并请一位信任的人陪同、帮助记录。
• 请医护人员直接对你说话，用你听得懂的方式解释，并把指示写下来。
• 如实说明发生的变化，尽量举具体例子。

需要更多沟通帮助时

可以请医生转介语言治疗师（speech-language pathologist）。他们能评估语言困难并教授替代沟通方法；对原发性进行性失语者尤其重要。

依据：《给认知障碍人士的沟通策略》第 2-4 页；《日常沟通》第 5 页。

“反应性行为”包括攻击、烦躁、来回走动、坐立不安、幻觉、多疑、发出意外声音或变得退缩。这些行动、话语或手势，常是在回应令人不舒服、挫败或混乱的身体和环境。

先问：她可能在告诉我什么？

六步找办法

1. 客观看行为。发生了什么？它真有危险或让人痛苦，还是只是与我们的习惯不同？
2. 找前因。之前有什么人、声音、任务、时间或身体不适？行为在何时何地最常出现？
3. 列出可能原因。把疼痛、疾病、基本需要、感官、环境、情绪和生活史都考虑进去。
4. 想几个温和策略。选择最符合她过去习惯、喜好和当前能力的方法。
5. 一次试一个。这样才知道是什么起作用。
6. 记录结果。无效时不要责怪任何人；换一个策略，并请医生、照护团队或协会一起分析。

常见情况：可以先试什么

依据：《认知障碍与反应性行为》第 1-7 页；《日常沟通》第 3-4 页。

一个人有决定能力，通常指她能理解与该决定有关的信息，并理解不同选择可能带来的后果。决定能力与“家人是否同意这个选择”不是一回事。记忆不好也不自动代表没有能力。

帮助她自己作决定

• 选她最清醒、最舒服的时候；先处理疼痛，戴好眼镜和助听器。
• 关掉电视，减少干扰；用简单语言、图片或实物说明。
• 一步一步讲，减少选项；“现在洗澡还是晚一点？”比“你什么时候想洗？”更容易。
• 给足够时间。重要决定可以分几次谈，不一定一次完成。
• 用纸条或录音帮助记忆并记录她的选择。
• 在尝试不同支持方法仍不成功后，才考虑由他人代为决定；必要时请医疗专业人员进行能力评估。各省和地区规则不同。

尽早安排三件事

1. 选定替代决策人。选择有时间、尊重她的价值与愿望、能在压力下合作并处理冲突的人。
2. 持续谈，而不是只谈一次。讨论医疗、生活、财务、个人照护和生命末期偏好。
3. 按当地法律写下来。尽可能完成正式文件，记录愿望并指定替代决策人。预先指示和替代决策法律因省/地区而异，应咨询当地协会和法律专业人士。

家庭可以一起回答的问题

替代决策人的原则

尽可能执行她已经表达的愿望，而不是自己的偏好。如果愿望不清楚、无法执行或家人意见冲突，应回到她的价值观，比较风险与益处，以及对她身体、情绪和生活质量的影响；必要时请一位中立、可信的第三方协助。

依据：《关于决策的对话》第 1-6 页。

每天快速看一遍

• 今天是否有新的疼痛、发热、便秘、尿路症状、跌倒或明显精神变化？
• 眼镜是否清洁，助听器是否戴好、电池是否有电？
• 是否喝够水、吃过东西、上过厕所、休息够了？
• 环境是否太吵、太亮、太暗、太拥挤或太冷太热？
• 今天有没有一件有意义、熟悉并能成功完成的活动？
• 我们是否给了她选择、时间和直接参与的机会？
• 今天有没有笑一笑、握握手、听熟悉音乐或安静陪伴的时刻？

行为记录：写四行就够

走失时要知道的特点

原资料提醒：走失的认知障碍人士可能不知道自己已经迷路；可能一直直走，越过田野、溪沟或障碍，最后停在灌木、排水区、树林、道路或铁路附近；可能躲在视线之外，不呼救，甚至听到名字也不回应。

建议提前准备一张信息卡

• 近期照片、常用姓名、常去地点、可能寻找的人或旧住址。
• 诊断、重要药物、沟通方式和紧急联系人。
• 定位设备信息；一份给家人，一份保存在手机里。

依据：沟通口袋卡第 2 页；《认知障碍与反应性行为》第 3-6 页。信息卡为本整理稿的实用建议。

Brant, Haldimand Norfolk, Hamilton Halton 阿尔茨海默协会（ASBHNHH）为认知障碍人士、家人和照护者提供教育、咨询、支持小组、系统导航与健康活动。First Link 可从确诊或轻度认知障碍开始，贯穿整个历程，帮助连接社区信息和服务。成为登记客户不一定需要正式诊断；部分活动也向公众开放。

可以询问的服务

支持小组范围

照护伙伴可询问：一般照护者、配偶、成年子女、长期照护、年轻发病照护者、男性、女性及 2SLGBTQ+ 小组；也有额颞叶认知障碍、路易体认知障碍、自我照护、悲伤与失落，以及丧亲后照护者小组。认知障碍人士可询问早期、轻度认知障碍和年轻发病小组。

主要办公室（来自 2025 年项目指南）

依据：《2025 项目指南》第 2、4-20 页。

这不是逐页逐句的完整翻译。三份沟通资料有大量重叠，因此合并为“理解变化、十个沟通习惯、本人自我表达”三章；决策与行为资料分别独立成章；项目指南则保留服务类别和联系方法，不重复可能已过期的详细课表。

重要免责声明

本手册仅供信息和家庭参考，不是临床诊断、治疗、法律或财务建议。每个人的情况不同；症状或行为突然改变时，应寻求医疗评估。关于决定能力、预先指示、授权和替代决策的法律规则，因省和地区而异。

原始资料版权归各发布机构所有。本中文稿是为家庭阅读制作的非官方整理版本；如需公开传播、出版或代表协会使用，应先取得相应许可并由协会审核。

整理日期：2026 年 7 月。内容依据用户提供的六份 PDF；未将 2025 年课程时间视为当前课表。

When you do not know what to do

1. Slow down. Lower your voice, allow space and make the situation safe.
2. Name the feeling. Try: “You look worried. I am here with you.”
3. Check physical needs. Pain, toilet, hunger, thirst, temperature and fatigue.
4. Reduce stimulation. Turn off the television, say less and do one thing at a time.
5. Offer two simple choices. “Tea now, or in ten minutes?”
6. Pause if it is not working. Change the person, time or approach, then observe again.

Sources: Communication pocket card p. 1; Day to Day: Communication pp. 3-6; Dementia and Responsive Behaviours pp. 2-5.

Dementia is an overall term for symptoms caused by disorders affecting the brain. It may affect memory, thinking, problem-solving, language, mood and behaviour. Alzheimer's disease is one cause; vascular dementia, Lewy body disease and frontotemporal dementia can have similar or overlapping features.

Changes you may notice

These changes are not laziness, stubbornness or deliberate non-cooperation. As language decreases, expression, posture, movement, vocalization, behaviour and touch become more important.

Support remaining abilities

• Arrange regular hearing and vision checks. Keep glasses clean and hearing aids working.
• Begin with what the person can and likes to do: setting a table, familiar music, gardening, art or folding towels.
• Remember the continuing need for companionship, purpose, belonging and respect.
• Watch non-verbal signs. A grimace, guarding part of the body, withdrawal or pacing may indicate discomfort.

Sources: Day to Day: Communication pp. 1-5; Communication Challenges and Helpful Strategies pp. 1, 3-4.

1. Approach from the front and introduce yourself. “Hi Mom, it is Lina. I am here to have lunch with you.” A gentle reminder of identity and purpose can help even with familiar people.
2. Gain attention first. Face the person, make natural eye contact, move slowly and avoid a sudden touch from behind.
3. Use the preferred name. Speak slowly and clearly in a calm tone. Avoid baby talk, “elderspeak” and patronizing language.
4. Offer one idea at a time. Short sentences are easier than long explanations. Finish one step before presenting the next.
5. Turn open questions into simple choices. “Tea or coffee?” is easier than “What would you like?” Yes-or-no questions can also help.
6. Allow time to answer. Wait quietly. Do not rush to answer for the person or show impatience.
7. Listen, then check. “Are you saying your shoulder hurts?” Offer a missing word only if help seems welcome.
8. Show as well as tell. Point to the door, bring the coat, use a photo or gesture, and let actions support words.
9. Acknowledge emotion first. “That sounds frightening.” “You want to go home, don't you?” Feeling understood can make the next step easier.
10. Use touch gently and watch the response. Holding a hand may comfort one person; sudden, rough or unwanted touch may increase stress.

Replace correction with connection

Make the setting part of the solution

• Turn off the television or radio and reduce competing conversations.
• One-to-one or small-group conversations are often easier than large groups.
• Avoid figurative phrases, sarcasm and humour that depends on fast interpretation.
• If either person is becoming distressed, pause and try later at a calmer, more alert time.

Sources: Communication pocket card p. 1; Day to Day: Communication p. 6; Communication Challenges and Helpful Strategies pp. 2-3.

• Tell people, “I need more time to find the word. Please wait before finishing for me.” If you prefer help finding words, say that too.
• Ask the other person to slow down, use short sentences or repeat. Move somewhere quiet if noise is getting in the way.
• Choose one-to-one conversation when a group feels tiring. It is okay to let a lost thought go; it may return later.
• Use notes, calendars, phone recordings, pictures, drawing, gestures and body language.
• Rest before an important conversation. Treat yourself with the same patience you would offer a good friend.
• Stay socially connected where possible. A support group can connect you with people who understand.

Prepare one page for a health appointment

• Write down changes since the last visit, symptoms, medications and the three most important questions.
• Ask for a longer appointment when possible and bring someone you trust to help take notes.
• Ask the provider to speak directly to you, explain in plain language and write down instructions.
• Describe changes honestly and use specific examples.

When more communication support is needed

Ask a physician about referral to a speech-language pathologist. They can assess language concerns and teach alternative communication strategies. Their support is particularly important in primary progressive aphasia.

Sources: Communication Challenges and Helpful Strategies pp. 2-4; Day to Day: Communication p. 5.

Responsive behaviours include aggression, agitation, wandering, restlessness, hallucinations, paranoia, unexpected noises and withdrawal. These actions, words or gestures often respond to something uncomfortable, frustrating or confusing in the body or environment.

Ask: what might the person be telling me?

A six-step problem-solving loop

1. Describe the behaviour objectively. Is it dangerous or distressing, or simply different from our preference?
2. Look for what came before. Which people, sounds, tasks, times or physical symptoms were present? Are there patterns?
3. List possible causes. Include pain, illness, basic needs, senses, surroundings, emotions and life story.
4. Consider gentle strategies. Choose options that fit the person's routine, preferences and current abilities.
5. Try one at a time. This makes it easier to know what helped.
6. Record the result. If it did not help, blame no one. Try another approach and seek input from healthcare, care teams or the local Society.

Common situations and first options

Sources: Dementia and Responsive Behaviours pp. 1-7; Day to Day: Communication pp. 3-4.

Decision-making capacity generally means being able to understand information relevant to a decision and the possible consequences of the options. It is not the same as making a choice that family members consider “good.” Memory difficulty does not automatically mean incapacity.

Support the person's own decision

• Choose the person's most alert and comfortable time. Address pain and make sure glasses and hearing aids are in place.
• Turn off the television and reduce distraction. Use plain language, pictures or objects.
• Guide one step at a time and reduce choices. “Now or later?” is easier than “When?”
• Allow time. Important decisions can be discussed across several conversations.
• Use notes or recordings to support memory and document the person's choice.
• Only move to decision-making on the person's behalf after different supports have been tried without success. A professional capacity assessment may be needed; laws vary by province and territory.

Plan three things early

1. Choose a substitute decision-maker. Consider availability, respect for the person's values, ability to collaborate under stress, and conflict-resolution skills.
2. Keep talking. Discuss healthcare, living arrangements, finances, personal care and end-of-life preferences more than once.
3. Record wishes through locally valid documents. Advance directives and substitute decision-making laws vary. Seek local Alzheimer Society information and legal advice.

Questions families can answer together

For the substitute decision-maker

Follow the person's expressed wishes whenever possible rather than substituting your own. If wishes are unknown, unclear or impossible to follow, return to the person's values, the risks and benefits, physical and emotional wellbeing, and quality of life. A neutral, trusted third party may help with conflict.

Source: Conversations About Decision-Making pp. 1-6.

A brief daily check

• Any new pain, fever, constipation, urinary symptoms, fall or marked mental change?
• Are glasses clean and hearing aids in place with working batteries?
• Has the person had fluids, food, toilet access and enough rest?
• Is the setting too loud, bright, dark, crowded, hot or cold?
• Was there one meaningful, familiar activity the person could complete successfully?
• Did we offer choice, time and direct participation?
• Was there a moment of laughter, touch, familiar music or quiet companionship?

A four-line behaviour note

Patterns when a person is lost

The pocket card notes that a lost person with dementia may not know they are lost. They may continue in a straight line across fields, creeks or obstacles, then stop in brush, drainage areas, woods, or near roads and railways. They may be hidden, may not call for help and may not respond to their name.

Prepare an information card

• A recent photograph, commonly used name, familiar destinations, people they may seek and former addresses.
• Diagnosis, important medications, communication needs and emergency contacts.
• Locating-device information; keep a copy with family and on the phone.

Sources: Communication pocket card p. 2; Dementia and Responsive Behaviours pp. 3-6. The information card is a practical editorial suggestion.

The Alzheimer Society of Brant, Haldimand Norfolk, Hamilton Halton (ASBHNHH) provides education, counselling, support groups, system navigation and health activities. First Link connects people with dementia or mild cognitive impairment and their care partners with information and community services from diagnosis through the disease journey. A formal diagnosis is not required to become a registered client; some programs are also open to the public.

Services families can ask about

Support group range

Care partners can ask about general, spousal, adult-child, long-term care, young-onset, men's, women's and 2SLGBTQ+ groups; condition-specific frontotemporal and Lewy body groups; self-care, grief and bereavement groups. Groups for people living with dementia include early-stage, mild cognitive impairment and young-onset.

Main offices listed in the 2025 guide

Source: 2025 Program Guide pp. 2, 4-20.

This is not a line-by-line reproduction. Three communication publications overlap substantially, so their content is combined into chapters on understanding changes, communication habits and self-advocacy. Decision-making and responsive behaviours remain distinct. The local guide is summarized by service type and contact route; detailed 2025 schedules are not repeated as if current.

Editorial choices for Society review

• Uses “person” before diagnosis and avoids infantilizing language.
• Frames behaviour as communication and emphasizes medical assessment for sudden or new changes.
• Separates decision-making capacity from whether others agree with a decision.
• Adds a brief emergency-services instruction and an information-card suggestion for family usability; these are identified as editorial additions.
• Does not treat 2025 class times as current. Contact details are attributed to the supplied 2025 guide.

Important disclaimer

This companion is for information and family reference only. It is not clinical, treatment, legal or financial advice. Individual circumstances differ. Sudden changes in symptoms or behaviour warrant healthcare assessment. Rules concerning capacity, advance directives, powers and substitute decision-making vary by province and territory.

Copyright in the source publications remains with the respective publishers. This unofficial adaptation should be reviewed and permission obtained before public distribution, publication or representation as an Alzheimer Society resource.

Prepared July 2026 from six PDFs supplied by a family. The 2025 program timetable was not treated as a current 2026 schedule.