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Totally agree - you're giving wonderful advice. People do not recover from dementia as they would a mental illness, so there's no point in trying to "ground" them in reality. Some caregivers of one of my loved ones (now deceased) were instructed to "keep her grounded" and they were constantly correcting her which resulted in extreme frustration for her - she would always say "well, you know I can't be making this stuff up!" It frustrated me too, because I knew she just couldn't give up those harmless delusions, and it would have made her so happy to hear them just say "oh that's interesting" or something like that.
In my experience ( this is now my fourth loved one who has had dementia) giving them validation and a little joy makes for a happier person, and after all, that's what we caregivers and friends want for our loved ones with dementia - some version of calm and happiness, where agitation doesn't rule every moment, which is a real challenge for many with dementia.
Here are three scenarios I have to deal with constantly, and so far, these "therapeutic conversations" have worked well for my loved one and me. Maybe some version of these can help someone else:
My loved one wonders where her (deceased) spouse is and why he doesn't come to get her. If I tell her he's been gone for 20 years, not only would she be shocked that she can't remember his death, but she would be so sad, and then tomorrow it starts all over again. So my answer is always some version of this: oh, you know how he always liked to travel - I think he must be out on a job, or some sort of trip, don't you? I'm sure he'll catch up with you later.
On other days, she is just sure her mother is going to come and pick her up and take her home. She always wants to know why her mother can't come and get her. My answer: Gosh, I bet she's awfully busy taking care of all those chores she has to do, don't you think? (feeding chickens, doing laundry, etc) I know she's had her hands full for quite a long time. I'm sure you'll find out soon what's going on. Until then, we'll just have to wait and see what happens. Try not to worry.
And when she tells me people are stealing her things or someone is beating her up, pointing to non-existent bruises (neither are true), I express sympathy and surprise, and then redirect, something like this: oh my goodness! That's so strange! I don't know how you manage to deal with all this, but you're strong - I know you'll come out all right. Someone will find your things, make a report, etc, etc. At least you still have (your nice blanket that your grandma made, your puzzle book, your new box of kleenex, etc) - remind me about that time you...(did something) or... remember when you broke your ankle? You sure had a lot to go through then! etc - keep gently redirecting rather than correcting.
Beautiful article and well said! After providing medical care for 35 years for my patients, I wholeheartedly agree that letting them HAVE the thoughts and beliefs that bring them comfort, joy and peace is part of good end of life care. IF it does NOT hurt or threaten them or others, go with it! 🤗
I love this!! I am so glad I read this as I am caring for my uncle and i constantly correct him and it does not work and just creates frustration so I think I will use the value of this in my own situation thank you!
I truly enjoyed reading this article. My mother lives in a lovely Assisted Living facility. We have had to make some accommodations to keep her there rather than the memory care unit. We have done this so that she still might have some feeling of autonomy. My mother's dementia is significant; her eyesight is practically nonexistent with many visions; she basically cannot walk although she sometimes surprises us by using her rollator and moving through the halls. She, like many of the loved ones described in this article, talks to and about people who are long gone. I go back and forth as to whether I indulge her thoughts. She makes me chuckle, however, when she thanks the other residents who are sitting at the dinner table for coming to her party. They, who are all much more functional than she, indulge her also by thanking her for the invitation - so very sweet of them. But, it is when my mother says she wants to go home that I am lost. It makes me sad. We take her through her room identifying everything that is hers - artwork, pictures, furniture. Sometimes successful... other times tears. But, she is so sweet and everyone seems to love her. They help in so many ways. We are thankful to everyone with whom we have contact through this journey.
I take care of my mom whom has dementia, and I was clueless at first about it. So i would correct my mom on things, but as I learned it is easier to go along with " her reality". As long as she is safe. I do get sad since I've noticed it's progressed....there are times now that she thinks I am her sister....at times I just laugh and she laughs with me. And it's that smile I'll keep in my thoughts when I will no longer have.
This is lovely and is very helpful to me as I navigate my own father’s dementia. The hardest ones for me are that he believes family members who have passed long ago are still alive. He asks how they’re doing (I can manage this one) and why they haven’t come to visit. That one is hard! Especially about my own mother. She passed 4 years ago and he wonders what she’s doing, why she hasn’t come,etc. I really struggle with that one. But, back to how you have handled your father’s realities makes me feel better about how I’m doing.
This is exactly what my sister and I do. It works 95% of the time. The other 5% is we use older music.( Ink Spots, etc.). He calms right down. He is 91
I cannot go along with my mom's reality. She accuses the workers in her personal care home of yelling at her and beating her up. My mom thinks everyone is stilling her bags of potato chips. She is afraid of every noise. I visit my mom everyday and have not noticed any abuse. I know her accusations are false because she accused the nurses in the hospital and her skilled nursing home as well.
I believe you are correct, in some cases. But my mother’s delusion cannot be indulged. Her delusion is based on the promise of a very famous person in the news to come pick her up in his private jet and take her to see his Florida estate. This was supposed to happen on July 4th, and now a month later, she has become increasingly agitated that he hasn’t shown up yet. She is angry, and in tears, and is now attacking me out of her frustration. I cannot think of any way to go along with this. I am certainly not going to take her there myself! I would let her obsession with this particular person just go in one ear and out the other, but it upsets her so terribly that I can’t just ignore her distress. I have no idea how to handle this. I hate that her condition is suddenly requiring me to have the skill of a licensed psychologist or something. That is NOT where my talents lie. I’m lost on what to do.
I agree to play along as it hurts no one, but if it gets to the point where they are accusing others of stealing from them then that's a different story. Each and everyone has their own dementia world to live in. In my mom's world, she would misplace things and when she couldn't find them, she would accuse me, any and everyone of stealing from her. Eventually, people stopped visiting because of the accusations. I was appologizing to each and everyone. So I decided to take her around the house looking for lost items. We always found them but she'd say how did it get there? Who put that there? Etc. She could never understand or admit she was her own enemy. I would never play along with her while she accused loved ones and caregivers of stealing when i knew for a fact they weren't. After a while mom would then ask herself out loud " now, where did I put that damned thing" lol
A friend of mine worked in memory care for many years, and her advice was very similar to this: agree whenever it didn't do any harm, and even redirect them to related harmless activities. She often dealt with patients who wanted to go home or who were convinced family were coming to take them home. Rather than arguing with them, she'd ask them to pack their suitcase in preparation for their "trip". Often the patients would start packing, then eventually lose the temporary urgency and move on to other things. Unpacking the few things that got moved was then much less stressful for all involved than trying to convince them that they were not leaving/their family wasn't coming.
I'm going to say no, don't play along or argue with delusions. I say this because I have been looking after dad 24/7 for five years now and what I find is that both things confuse him. For me, the trick is not to lie. I am gentle in my re directions, silent through his agitations and respond to him without reacting to his disease. I drop subtle orienting hints---but I don't indulge delusions because they grow and grow and grow and he winds up more and more confused. And I don't argue with them because as the commenter said, his reality is his perception, so there is no point in that either.
Thank you for your efforts with your Dad...you gave him peace! How you did....was the results of "living your early years" with Him and your Mother. They gave you a posative mind set.
The physician's advice would have made sense if dad was a psychiatric patient with a chance of recovery and a need to distinguish reality from delusion. That is, in fact, the way medical people are trained to deal with the delusions of mental patients. BUT dad was NOT a psychiatric patient! There was NO chance of of his delusions harming him. His version of reality was enriching his life, not hampering or endangering it!
When his imaginings were frightening, he could be redirected, as his daughter did so artfully! Bless this loving daughter for the time and trouble she took to bring pleasure to her father in his last days.
Loved the article. What wonderful memories to have of your father. What a wonderful daughter. I found going along with my father's reality was easier than trying to "ground" him in reality (I always said I was vising his delusions or his universe). He was in hospice and after moving from AL with my mother to SNF he declined more quickly. His delusions were more mundane - no degrees, no zoos to plan. He was only in the SNF 4 months until his death. His delusions centered more around money, we didn't have a lot of money growing up, but we had a roof over our head, plenty of food and clothes on our back - more than others had. He didn't have a lot of delusions in those 4 months - just a few. But as long as the answers to her alternate reality didn't agitate him more it was easier to go along. I now remember a couple of the delusions and it makes me smile.
While others call it a therapeutic lie; I call it visiting their alternate reality.
I needed to read this article. My Mom has dementia early stage. So sometimes she is "with the program" and some days not. I quite my job/career, left my friends and my beloved San Diego to move in with her and take care of her. I've been living with her for a few years now. What a life-changer for me. I constantly need to remind myself to be more patient and understanding. Jesus is definitely in this picture to help me cope. My Mom is 93 now and most days is still doing as well as she is able. I think my problem is that I am not just the caretaker, but I am her daughter and I keep expecting her to be the same Mom she used to be. And I get impatient when she is not and I have to repeat everything three times. But I do recognize my faults and flaws. I just wanted to say thank you for this article you wrote. I need to accept her world and stop trying to bring her into mine. Thank you Carol!
My LO was convinced that a mysterious man was burning his feet at night. He was quite irrational about it and was so angry that I was not barring this person from the home. However, because he had diabetic neuropathy the pain was real. I never knew what to do about it, can't go along with the delusion because that causes so many other issues as did not dealing with it. It was the worst with no solution.
This was one of the best articles!! It brought me many smiles & gave me much to consider. I think your Dad and his educational delusions are delightful. I wish that were the case all the time w/ my loved one. On a good day, our loved one has delusions that she’s on a cruise ship, something she loved to do over the course of her life. My husband and I support this delusion because she always happier then.
My mother had dementia and had also lost much of her visual acuity, and lived in a nursing home. Between missed deadlines and stringent voter requirements a few years ago, we missed deadlines for an absentee ballot in a statewide election. My mother had been civically engaged all her life, and still understood in basic ways political news on TV. When my efforts to obtain a ballot for her failed, I didn't have the heart to tell her...so I made a counterfeit ballot on over-sized blue card stock and copied the candidates and referendum questions so that I could read aloud her choices and she could 'vote.' I made recommendations if she got stuck. She was so proud, and that one exercise did so much for her dwindling self-esteem. It didn't ease my own guilt, but it was the best I could do in a bad situation. That said, in my state facilities are required to assist residents in voting (mainly by acquiring absentee ballots, while the best even arrange for an election official to conduct legitimate voting onsite). I was too overwhelmed to take on that battle at that time, though I'd have done differently today. Often fantasy is much nicer than reality, and if positive fantasy improves one's quality of life and hurts no one, it can be a gift.
As for the father with an embellished resume, my mother was thrilled when I presented her with a laminated place mat I created with color copies of her HS diploma and college and master's degree graduation certificates. She asked me to hang it up so people could she was smart. We continued her newspaper subscription as it had been part of her daily ritual forever, well after she stopped being able read and comprehend, until she came not to even notice it was there. Then we kept it for us to keep us sane during endless early evening game shows...
"Creating moments of joy"- a book that speaks to this topic and CHANGED MY LIFE AND MY MOTHER'S AND IMPROVED her quality of life in countless ways. When I look back I regret not being more aware financially cuz I would have spent her leftover $ on a Willie Nelson impersonator. Read this book. It works! Live in their reality!
A beautiful story - thank you! It validates how I go with Dad's stories daily to simply love him and preserve his dignity at age 87. I write and edit professionally, so my world is about accurate storytelling. Being Dad's primary caregiver stretches me in many ways, especially in being flexible ... and learning to be okay with the wildly inaccurate tales of someone I love and respect dearly. :-)
It is so lovely to read this. Thank you. I too was roundly castigated for 'playing along' when staff were 'correcting' a person for believing her daughter was coming to take her on an outing. It always seemed so cruel.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
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Should You Join Someone With Dementia in Their Reality?
In my experience ( this is now my fourth loved one who has had dementia) giving them validation and a little joy makes for a happier person, and after all, that's what we caregivers and friends want for our loved ones with dementia - some version of calm and happiness, where agitation doesn't rule every moment, which is a real challenge for many with dementia.
Here are three scenarios I have to deal with constantly, and so far, these "therapeutic conversations" have worked well for my loved one and me. Maybe some version of these can help someone else:
My loved one wonders where her (deceased) spouse is and why he doesn't come to get her. If I tell her he's been gone for 20 years, not only would she be shocked that she can't remember his death, but she would be so sad, and then tomorrow it starts all over again. So my answer is always some version of this: oh, you know how he always liked to travel - I think he must be out on a job, or some sort of trip, don't you? I'm sure he'll catch up with you later.
On other days, she is just sure her mother is going to come and pick her up and take her home. She always wants to know why her mother can't come and get her. My answer: Gosh, I bet she's awfully busy taking care of all those chores she has to do, don't you think? (feeding chickens, doing laundry, etc) I know she's had her hands full for quite a long time. I'm sure you'll find out soon what's going on. Until then, we'll just have to wait and see what happens. Try not to worry.
And when she tells me people are stealing her things or someone is beating her up, pointing to non-existent bruises (neither are true), I express sympathy and surprise, and then redirect, something like this: oh my goodness! That's so strange! I don't know how you manage to deal with all this, but you're strong - I know you'll come out all right. Someone will find your things, make a report, etc, etc. At least you still have (your nice blanket that your grandma made, your puzzle book, your new box of kleenex, etc) - remind me about that time you...(did something) or... remember when you broke your ankle? You sure had a lot to go through then! etc - keep gently redirecting rather than correcting.
i was visiting her one day at her nursing home after she’d been diagnosed with alzheimers and she introduced me to her roommate as “uh … friend”.
i didnt correct her. She thought she had a friend who cared about her so who cared about who i really was.
i visited once a week and she’d greet me with open arms … really ! (I tried twice one week but she didnt recognize me the second time.)
i was a hospital nurse aide at the time but never wore my uniform.
all we can do is be kind … what difference does it make that psychologists think it’s wrong ?!
I would let her obsession with this particular person just go in one ear and out the other, but it upsets her so terribly that I can’t just ignore her distress. I have no idea how to handle this. I hate that her condition is suddenly requiring me to have the skill of a licensed psychologist or something. That is NOT where my talents lie. I’m lost on what to do.
In my mom's world, she would misplace things and when she couldn't find them, she would accuse me, any and everyone of stealing from her. Eventually, people stopped visiting because of the accusations. I was appologizing to each and everyone. So I decided to take her around the house looking for lost items. We always found them but she'd say how did it get there? Who put that there? Etc. She could never understand or admit she was her own enemy. I would never play along with her while she accused loved ones and caregivers of stealing when i knew for a fact they weren't. After a while mom would then ask herself out loud " now, where did I put that damned thing" lol
When his imaginings were frightening, he could be redirected, as his daughter did so artfully! Bless this loving daughter for the time and trouble she took to bring pleasure to her father in his last days.
While others call it a therapeutic lie; I call it visiting their alternate reality.
Thank you Carol!
As for the father with an embellished resume, my mother was thrilled when I presented her with a laminated place mat I created with color copies of her HS diploma and college and master's degree graduation certificates. She asked me to hang it up so people could she was smart. We continued her newspaper subscription as it had been part of her daily ritual forever, well after she stopped being able read and comprehend, until she came not to even notice it was there. Then we kept it for us to keep us sane during endless early evening game shows...
Blessings to you all. We just carry on.