How do you handle dementia related accusations?

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How do you handle dementia related accusations?

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My mother is 90 and has recently had a stroke, which left her with very poor speech skills and vascular dementia. In rehab, she became suspicious and paranoid, pointing out aides and saying 'don't trust him', thought people were talking about her, thinks she's being given the wrong medication or no medication. We know these things to be untrue. In general, I know that you're supposed to play along with folks with dementia, but I can't agree with her about this stuff, or should I?

Alzheimer's & Dementia

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My dad had encephalopathy while he was in a nursing home. Swelling of the brain. He had all the symptoms of Alzheimer's and he too was very paranoid. He thought the staff was out to get him. Initially he was empowered by these thoughts because in his mind he knew what was supposedly going on, he had the power because he was aware (all of this was in his mind) but then as the illness progressed he became a 'victim' of the staff. I listened to him and told him that I would take care of it. He would beg me not to, he was so afraid, but I would ask him if he trusted me and he said he trusted me the most out of anyone so I told him that I would take care of it. I promised him. This pacified him for the time being. When it would come up again, as it always did, I listened to him, told him I would take care of it, then redirected him. Redirecting takes so much energy, I know, but I would tell him a funny story or ask his advice on something. Get him going in another direction. But I felt that listening to him was respectful even though I knew what he was telling me was all in his head. I'd bring photos with me and whip them out to redirect him or I suggest we go down to the library where it was very sunny and bright.

So no, you can't agree with your mom but you can listen. I used to imagine what it must be like for my dad. I knew he wasn't in any danger but that was his reality, his truth, and how scary that must be for him to know that people are out to get him. Be comforting to your mom, reassure her as I would reassure my dad, and then gently redirect her attention.

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I have to somehwat agree with ferris1. It's difficult nearly impossible to reason with Alzheimer's/dementia patient.

I completely understand. I am a caretaker for my fiances grandfather (who has Alzheimer's) and get accused of "stealing" or "hiding things in his desk". "every time we come over here she hides it". Most commonly it's his pistol that he wants (which is no longer available to him), but it's anything. For a while it was his nose spray...really like I have the desire to hide nose spray? Or his phone which will be on his charger next to his bed. Or his remote control...of course I put it in the desk as well. Obviously, or at least I hope it is, all of this is untrue. I became very weary and upset. Knowing the truth, but also knowing that his brain is not completely functional. The simple stuff like nose spray, cell phone, toothpaste etc I just help him find it. With the stuff that he is not allowed (keys, pistol, pocket knife) to have we have formed a story that he left his pistol in his truck and his son borrowed his truck. It might sound wrong but this has helped us tremendously. ---P.S. we tried the whole "distraction". Nope doesn't work on this situation. Only distraction that has worked is a watergun fight. & my apologies...I'm not always up for one of those.

He also believes his mother is still alive, she passed away nearly 20 years ago. Besides, if he's 77...it's very unlikely his mother is alive. But you can't reason that. & I also refuse to tell him his son died. It took me 4 hrs to calm him down & get him on another subject--he wanted his pistol so he could kill himself. So he might say "I don't think my mother has ever been here", I respond "I think you're right". and move along with another subject.

You have to use your best judgement and figure out what works best. I live with him & I want to try to make it as positive as possible. Hopefully this helps.

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It might help to think of it this way: there are several "truths" and you can find and validate the one that matters most. It's not true that, let's say for example, everybody is out to get her. It IS true that she's anxious. If she were able to say "I'm anxious" you'd find it easier to focus on that. She can't say it that way, but you can make the translation.

Then you have a choice about how to respond to her feelings. Most of us have learned to say stuff like "well, relax, it's ok" and "no they're not" and other such reassurances. But that really boils down to telling someone not to feel what they are feeling. The intention might be loving but the effect isn't. And notice, those are all essentially arguments about what's true again: are they out to get her or aren't? We're back there again.

So instead you take the only truth that matters: She's anxious, period. Nobody wants to suffer so if it were easy to decide not to be anxious, she would. What do you do with that truth? Just be with it. "Sounds like something's worrying you. I can see how tough it is for you." That's not agreeing with some un-truth, it's acknowledging the truth of her feelings. Don't worry, it won't make her feelings worse or fuel the fire.
What WOULD fuel the fire would be (1) if you stayed on that topic for a long time, (2) if yourself went along with those feelings by becoming anxious yourself, (3) if you went rushing around trying to solve the problem as she sees it. Those all give the message, "yes, there's a problem." So you stay calm, and you move on to something else. YOUR moving on is what makes redirecting work for HER.
This is all a crash course in empathic relating, isn't it! Turns out, it's applicable to ALL our relationships, with EVERYBODY!! Whoa! I'm still working on it......

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I try not to argue with my mother, but if she were to say that I had not fed her or given her the daily medications, I would correct her by saying something like, "Oh yes Mom you took your medication at dinner, or Oh Mommy we had such a good dinner tonight it was........" I do tell her information she has forgotten but if she continues on or becomes angry and insists that I am wrong, sometimes I just say "okay Mom" or sometimes I IGNORE HER. We use to ignore a lot of our children's ramblings and now we have to ignore our parents ramblings. If your Mom says she doesn't trust someone, I would quietly ask, "Why do you say that Mom?" If she doesn't say I saw him going through my purse and just really has no concrete answer then I might say, "You know who he looks like to me? Remember Cary Grant, doesn't he look a little bit like him, do you remember that funny movie he made..." then just go off into another conversation about the old movie.

If you are going to argue everything they say incorrectly you will drive yourself and them crazy! It is frustrating, I admit it but you would be surprised how many things they let go of, if you just do not respond to just being up a different conversation out of the blue. It works.

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Who told you you had to "play along with" untruthful remarks your mother says? If it is some silly thing okay, but when it comes to meds, tell her the truth. If she does not believe you, don't argue, just drop the discussion and change the subject. Trying to tell a dementia patient what the "real" truth is will only frustrate you and cause that patient to get anxious. You know the truth (whatever the subject is), and just disregard what she says (unless it might cause her harm). Instead focus on pleasant subjects, show her photos (if she still recognizes herself and others), and be loving.

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I don't think there is any set way of handling things. So much depends on the person and the circumstance and what the outcome would be if you went along with what they are saying. My mother is a confabulator who puts together stories of conversations that happened that back up something she is concerned about. For example, this morning she spoke of her concern that the floor was giving under her feet and that the house was going to fall down on us. She told me of a conversation she had with the person who did our foundation work. She said that he had warned her of the bad things that were going to happen if we didn't follow through on the work. Well... we did follow through on the foundation, the house is fine, and the conversation with the man never took place. She has been having the concern about the house for over a year now. It never changes, but the story keeps getting added onto with imaginary bits. This morning I simply asked her if she thought that maybe it had to do with the dementia. It made her stop and question herself.

In this case it was important to stop her thinking this way, because it would cost thousands of dollars. Sometimes we do have to put our foot down and do things to protect loved ones who are not thinking clearly. Good examples are taking away the car keys and large expenditures. I usually find that the way to handle things gently occur to me as needed, and that I don't need to follow a prescribed course that turns me into a false personality. We can be kind and truthful all at the same time if we just consider the best way to handle each situation as it arises. Sometimes ignoring is good. Sometimes distraction is good. Sometimes truth is good. It all depends on the person and the circumstance.

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Smiling: Right, by "applicable to all our relationships" I didn't mean it's the only way to relate. Of course you're not going to re-do the foundation of your house if it doesn't need re-doing. Whether or not she thinks you should, and whether or not you succeed in stopping her from thinking you should, is a whole 'nuther issue. Dealing with what demented people truly think, truly feel, and continually say -- in some kind and effective way, NOT taking them literally -- is what we're all struggling with.

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I've found that distraction works well too. I tell him it's time to take his pills, time to eat, suggest he go across the street to visit his friend ( they love that one!), go sit outside for a while, but I run out of distraction topics. He won't watch tv or radio (I don't think he understands what they're saying), doesnt like music, won't read any more, has no interests or activities to get him thinking about anything other than what he is currently fixated on. He is on quetiapine which has helped a lot with his psychotic behavior (hallucinations, delusions, paranoia, shouting) but still gets fixated on "someone" stealing his glasses, razor, wallet, underwear, shirts. Reasoning absolutely does not help--he starts shouting that he's not losing his mind and that only increases his paranoia that I'm trying to throw him out of his house. Distraction is the only thing that works, and when I can force myself to do it, praise him and tell him how wonderful he is. That gets harder an harder with each episode, however!

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She KNOWS she is right. And so are you, but since your neurons are still functioning and hers are not you have to figure out how to communicate with her on HER terms. You need to be creative and tell her things that apiece her and distract her with words, objects, music, drawings, photos, reading, tickle her, kiss her, and so on. This the ONLY way, unless you replace her damaged cells. If proper, ask those on her cross-fire to do pleasant things for her, like bringing her ice-cream, holding hands. Scientific studies have discovered that the brain responds to kisses producing hormones that act on the emotional center creating a sensation of pleasure and well being and calmness.

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Kashi60. You really need to put your husband in assisted living and assist him and reassure him that you will help "fix" the things that trouble him. He will say he hates you and can't believe you would do that. But as we've read here time after time, the person you knew isn't wholly there any more.

How do you handle dementia related accusations?

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