Blog – Coleen P. Kenny

How would you respond to the following remarks made by elderly people with dementia?

1. “Honey, my clothes have been stolen and I think my purse has been too.”

a. Your clothes are in your room; you just don’t remember.
b. Oh, dear. I’ll let Security know, and they will talk to you later.

2. “Should I go across the street now? My mother is waiting for me.”

a. Honey, your mom’s been dead for 30 years; your room is over here now.
b. Let me call and see if she’s home yet; and let’s find some juice while we’re waiting.

3. “The porch rail is broken because men come every night and beat on it with hammers. I hear them!”

a. The porch has been broken for the last year, there are no men; just come in the house.
b. I see what you mean; I will call the police to patrol tonight and see if they can catch the men.

If you chose b for all 3, you chose wisely. If you chose a, we need to talk…

The old rule of thumb was to try to reorient folks to reality. All this does is upset them and make a bad situation worse. Imagine if you truly believed that your husband or mom was still alive and everyone was telling you he or she wasn’t. Imagine that every time someone told you your loved one was dead, it was brand new information. Brand new grief.

Imagine if you misplaced your purse, or maybe you donated it ten years ago, and now you believe it’s been stolen. Imagine believing it’s 1941 and that your children are still elementary age and everyone’s telling you it’s 2011… how terrifying to lose that much time.

But in dementia, the reality is that the brain’s failing. It’s losing its old memories and can’t create new ones. So trying to reorient someone with this disease process is like trying to get a two year old who’s hell bent on having a tantrum in the grocery store to stop.

Sometimes you just have to go with the flow. Meet the person where they are at.

“Therapeutic fibs” as nurse/speaker Brent Longtin calls them.

They don’t hurt anyone and they can prevent a world of distress.

Would love to hear your feedback or stories…
Coleen

“I was ready for to deal with mom’s physical aging…I was never ready for this.” –words spoken by a Caregiver Daughter in my Dementia and Delirium talk today…

Deep emotion charged her words as she shared her struggles to reason with Mom and make Mom happy. Themes resonated through the room as others told of being accused of stealing misplaced items and of stories being created to cover for missing memories.

So I used an analogy I developed to explain Alzheimer’s type dementia: a cassette tape erasing as it unwinds…

We enter this world then breathe and eat and drink to survive. We learn to toddle then toilet train. Mom lets us dress ourselves (at times to her embarrassment), and we learn to bathe ourselves and do simple chores. Mom and Dad send us off to school and we learn to read and write and think, reason, and learn. Eventually, if Mom and Dad are lucky, we leave the nest. We make appointments and house payments. We buy groceries and balance our checkbooks and drive.

In Alzheimer’s Dementia (one type of dementia), the tape is erased. Money and time and cars and homes become unmanageable. The ability to bathe and dress is lost, not to laziness, but to inability to figure out very complex tasks we take for granted. Standing and walking, one foot in front of another in proper sequence and lift and balance, is compromised as the brain loses communication with the body. Toilet training is lost to incontinence. Swallowing is impaired leading to pneumonia. Appetite and weight are lost to the end stage of the illness.

But also lost is the ability to reason. To figure out new things. To cope with the fear of losing one’s purse or keys or home or mind. To communicate needs and thoughts and feelings.

And so the Caregivers are left to cope with these.

I told the daughter today that mom isn’t trying to drive her crazy on purpose. Breathe deep and step back and sometimes just nod and smile and say, “Okay, I’ll look into that” when the neighbor’s accused of stealing a pocketbook not seen for years. Because the person with the dementia believes it to be true.

And no manner of arguing, cajoling, bribing, yelling, huffing, or puffing will change that.

So this note is to you Caregivers…When you’re called to honor your mother who has dementia, remember you are not alone. And she’s doing the best she can, and that’s all you can do too…

My heart sighs for each one of you, and I will post more info on Dementia soon–please feel free to contact me if you have specific questions!