Can You Jump into the Reality of Your Loved One With Dementia?

 Today's salad is made up of two ingredients; theirs and yours.

 I can not count how many times I've listened to a family member fight with a dementia resident over the reality of things.

For instance, mom may say something as simple as "Where's dad?" and instantly it is on.

Sister- "Oh mom, you know daddy died 4 years ago."

"What? He died?! That's not true, why are you lying to me?!"

Brother- "geeze mom, no one is lying to you. Dad died."

Sister- "Ya mom, he had a heart attack in 2020."

"No he did not! How dare you tell me my Larry is dead!"

Now this conversation can last anywhere from a few seconds to 15 minutes or more.

Back and forth forrrrevvvverrrrr.

No matter how long it goes on it leaves the kids exasperated but it leaves mom heartbroken. 

You can see it in her eyes and in the way she clutches at her heart. You can hear it in the tone of her voice. The complete and utter devastation of losing her husband today.

This is the part that is so vital for families to understand. Mom has dementia. There are literal holes in her brain where all those memories used to be.

When you told her that her beloved husband of 50 years was dead, she was hearing it again- for the first time.

It had just happened in her world.

I know it can get old and maybe very painful for you to listen to her talk about your dad as if he's still here but do you remember what it felt like the very first moment you found out about his passing? That is the pain you are causing her every time you remind her that he's died.

Instead, why not jump into her reality. Go to her space with her.

"Where's dad?"

Answer-

He's shopping.

He's working.

He's walking the dog.

He's mailing a letter.

Whatever it is you can tell her in that moment to help relieve her anxiety about why he's not standing next to her.    Especially when the kids are over, he should be standing next to me!

Some people take issue with this approach.

"Well, we don't want to lie to her."

Typically, trained dementia caregivers call these therapeutic lies.

They are told to prevent our patient from getting upset or distressed by a truth they can no longer understand. 

Not only that but the dementia resident will forget what you told them in a moments time. Therefore you would have to keep telling them this information over and over and over; continuously stabbing them in the heart because they MUST know the truth.

Another way to handle things is by simply letting them answer their own question.

"Where is dad?"

"Where do you think he might be?"

"I think he could be at work."

"I bet you're right. He probably is at work."

Again you are engaging that therapeutic lie at the end but overall you are letting them answer their own question and essentially calm their own fears.

Another tactic you may want to try is diversion/distraction or redirection.

If you are able to get your loved one to move on to another topic without actually  answering the question, that is a wonderful way to avoid the hurt that comes with trying to bring them back to reality.

"Hey Susie, where's dad?"

"Oh my gosh mom do you know what I did this morning?! I drove all the way to work in my slippers! I thought I had my shoes on but it turns out it was my slippers the whole time."

Or

"Hey Bobby, where's dad?"

"Mom, little Johnny here hit a home run at his ball game today! Can you believe it? 10 years old and already a homerun."

In a lot of cases redirection will work. If that is what you are most comfortable with, go ahead and try that first.

Sometimes it may only work for a little while and the therapeutic lie will still have to come into play but by all means, try it, it may be the golden ticket in that moment.

More than likely you have heard this from your loved one in one form or another.......

I want to go home now, can you take me home, please.

But dad you are home. You've lived here with mom for over 30 years. See, here's your bedroom. Here's the picture of you and mom on your wedding day. Here's your favorite hammer in your tool room. Here's the sink you installed back in 2013 and here is where you keep your socks.

"Thanks for showing me all of those things. Now can we go home?"

Now what? They are home, they live here but obviously they aren't accepting that for truth today, so what are you going to do?

Many caregivers have found that telling a therapeutic lie here is really the best way to go.

Mom, it is really raining out. We are going to stay here tonight and head out in the morning. They even have a bed set up for us. Isn't that nice of them?

Or

Hey dad, this is my favorite home. You are my favorite person so I just wanted to share it with you tonight. Can we leave out in the morning?

You can usually get your loved one feeling safe and comforted with little to no stress.

One final scenario I wanted to talk about today, I mentioned in a previous blog. Your loved one may think they are much younger than they actually are, therefore... "You can not possibly be my little Bobby, he's only 10."

This is a bit harder to diffuse. 

It can also be harder on you, since you really want mom or dad to recognize you as you stand today.

It's at this point that we must remember,  we have to change our way of thinking because they can not.

No matter how much you beg, borrow or cajole, if mom thinks she's 40 she will never understand that you, her son, are 52.

If you want to have any bit of relationship with her today you need to meet her where she is.

"Oh hey, that's really neat that today is your 40th birthday. Happy birthday. I heard you have a little boy named Bobby. How old is he now?"

Who knows, you might hear some great stories about your childhood. Maybe you will learn something about yourself you never knew. You will probably also hear the pride and love your mother poured into you when you were little.

Although these aren't the precious moments you planned on for today, they can still mean the world.

Letting mom relive those past moments also does wonders for her. It brings something to life inside of her that had not been there 5 minutes ago. Although it may not be there 5 minutes from now either,

she had it, no matter how fleeting......

A moment of Joy

 Moments of joy are so very important to someone suffering from dementia. This  disease robs them of so much. The least we can do is give them the stars in their eyes, if even for a minute.

Therapeutic lies are a communication strategy that some health care professionals use in dementia care when it's in the best interest of the patient. They are prosocial lies told to avoid causing distress or harm that might result from telling the truth.

ASK THE EXPERTS

Teepa Snow; one of the top dementia educators in the U.S. Videos available on youtube.

Alzheimer’s Association 24/7 Helpline (1-800-272-3900) to vent, get advice, & resources.