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Embracing the Reality: Dementia

By January 15, 2015Dementia

“I don’t want to lie to her.” It’s amazing how often I hear people say this regarding a person with dementia. This is a good policy normally, but it just doesn’t apply when we are talking about dementia care.

Dementia care is challenging. Caregivers make it harder, though, when they refuse to accept that people with dementia live in a dementia-based reality. Dementia-based reality is not the same as ours. In dementia reality, people who have died are still alive, grown children are still kids, and retirees are still in the workforce.

Does the following story sound familiar?

Your mother is looking at the clock. “When are we going to Mom’s house?” she asks. Your mother is 85 years old, and her own mother has been deceased for quite some time.

In this instance, you could react in several ways. Sadly, many caregivers gravitate toward the wrong approach: “Mom, you are 85. Grandma has been dead for 20 years,” you might explain, annoyed that she is unclear about this. This information, however, is completely new to her in her reality.

Some caregivers believe that a little reminder will be helpful, but your mother is devastated by this information. “But when did she die?” she asks with tears in her eyes. Fifteen minutes later, she has forgotten that you have told her this, but she is still upset and agitated but does not know why.

A potentially better solution could be to redirect the conversation. “I am not sure. We could probably go tomorrow! What were you thinking of doing at Mom’s house?” you could ask. Maybe you could remind her of Grandma’s cooking, and how delicious her sweet potatoes always tasted. She may be happy to talk about this, and suddenly your negative conversation is a positive one.

When people with dementia get confused, family members sometimes feel the need to “orient” them to our reality. “I don’t want to lie to mom,” adult children will tell me. It’s not about lying, I reassure them—it’s about embracing the reality of the person with dementia.

Image Credit – http://www.beliefnet.com/columnists/jennifercares/files/import/Caregiver%20042.jpg

Rachael Wonderlin is a Dementia Care Program manager at Brookdale Senior Living. She has a Master’s in Gerontology from UNC Greensboro and has worked in many different care settings (hospitals, dementia care, assisted living, skilled nursing, and home care). Rachael keeps a blog called Dementia By Day.
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