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How to get into ADW LO's mind set? It has been suggested to find the feelings that cause the fixation. How to to do this

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My father came to breakfast one morning very distressed and anxious, because he had to get to a particular intersection on a nearby highway to help "Charlie" unload a truck. Heaven knows what memory this was attached to! It was pouring rain, and I assured him that Charlie wouldn't try to unload until the rain stopped, and certainly wouldn't expect Daddy to meet him there in the rain. I convinced him to have breakfast first. By the time he had eaten, he had forgotten all about it. As we later understood, my father was having a series of small TIAs over a period of days --- this episode was a prelude to a more serious event a few days later.
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My mom ruminates and obsesses about going back to CT all the time. She says she will move there with her sisters (who are dead and had lived in FL most of their elder years anyhow...) and she says she'll buy a car when she gets there and has to start packing. Thankfully, she has not begun the packing process (lol) but she does get on tangents. I know what she misses. She misses her life up there when she was healthy with her family with her. I never argue anymore with her about that. I just say, "Well, it's winter, let's wait a few weeks until the snow melts" and while she still grumbles, she doesn't stay on it. I find it satisfies her if I say let's just wait a week or a month.
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Redirect if possible, change the subject. Frequent and good advice. Can be almost impossible:)
AWD is at the do-over-stage
do-wait five-forgets - repeat the question or subject, redirect again and again,
do-wait five-forgets - repeat the question or subject, redirect again and again,
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I would suggest:
Never argue, there is nothing positive that will come from it.
Redirect if possible, change the subject. Get to know them and find something they like, for instance what's important to them. If it's family, ask them questions about their family.
Massage and music can also be good diversions.
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Do your best to keep the person reality oriented but not to the point where it becomes argumentative. I love this advice. Unfortunately I hit the first experiece with my Dad's sundowners thinking he was just being silly, and I thought I could bring him "back to his senses" with a firm negation of his statement that the room didn't have enough oxygen. Oh he had theories about it, and we examined all the windows. I wonder if it would have been easier had I gone along with it without contradicting him, but he needed action for his delusion - we needed to open the windows in order to breathe, he thought, and it was 20 degrees outside. So sad that he was so worried for us, that all in the house were in danger. Then the others derided me the next day for allowing him to crack a window. I am sorry, but I do not believe that it is good to destroy dignity for a little heating oil. One needs to live to old age, not just exist, as someone pointed out.
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Jeannegibbs your Bus answer is spot on. My husband AD 84 years old goes through the delusions daily, you definitely have to cross into their AD castle to get the train, bus, mother or whatever the issue derailed, it only takes me seconds to do that now. Hope this helps UncleDave. Jasper89 they are called night terrors I went through it for quite some time, then occasional, now none at all. Just don't try to reach out physically and touch him trying to reassure him in his sleep as you may get slugged, I learned the hard way as they don't know who is touching them.
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Oh Jasper, how sad. I'm afraid I have more questions than answers:
Does he also have movements? For example, does he wave his arms or kick?
I take it the sounds he makes sound like moaning in pain?
Does he have pain often in the daytime?
What stage is the dementia in? Do you know what type it is?

I'd start by talking to his doctor about this.
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How does one handle a dementia patient who makes very unusual and disturbing sounds in his sleep. That patient is my dear, sweet husband of 62 years. I just do not know the best way to handle this. I cannot tell if he is really in physical pain.
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Hit the wrong key and my reply was gone. Back to editing in open office and pasting.

FWIW: AWD translates to Alzheimer's Disease Wife.

My ADW is a retired Psych RN she would appreciate the comment: an old saying ….. “It goes like this: "the neurotic builds castles in the sky, the psychotic moves into the castles and the psychiatrist collects the rent." I said this to say - don't move into the castle with the person who has the delusions. Do your best to keep the person reality oriented but not to the point where it becomes argumentative.”

The train fixation is one of hundreds. It has many levels. Her dad worked for the Boston and Maine RR for years They commuted by train. We can hear lpcal RR trains whistles when they cross roads near us.

I am not able to watch TV because content shows up In delusions.

She was a serious pianist. Classical music on playing 24x7 {it makes her day}

I am addressing the symbology of the delusions to help in dealing with them with the help of a SW provided her by Mass Health. In fact this why I opened the topic. Forums reach thousands of individuals with great insights.

She is lucky, we have a terrific support network with indepth range of Alzheimer's experts. I spend my time while ADW sleeps developing mainzoneknowledgenetwork.blogspot.com/ . It is a work of love and not a penny of revenue

To toot my horn which helps me deal with caregiver stress:
I have been told that I fit the description a knowledge_worker.
As a Helper I transfer information to teach others, once they passed a problem. Assisting with dissemination, feedback, information search, learning, networking

As a Learner I use information and practices to improve personal skills and competence.

As a Linker I associate and mash up information from different sources to generate new information. Reading , dissemination, information search, information organization, networking

As a Networker I create personal or project related connections with people involved in the a wide variety of work, to share information and support each other.

As a Retriever I search and collect information on a given topic or variety of topics.

As a Sharer I disseminate information in a variety of communities.

As a Solver I share with who seek to provide a way to deal with a problem. Type your comments and experiences here.
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It took me quite a while to deal with my husband's bus and train delusions. But I think I finally got it right at the end. He came through the kitchen with a little packed paper bag and headed for the garage door.

Where are you going?
I'm going to catch a bus.
(Glancing at clock.) Oh, I am so sorry but there are no more buses tonight. Can it wait until tomorrow?
(Big sigh) I am soooo tired. I wanted to go home and sleep.
Well I'm sorry there are no buses, but I know of a place you can sleep tonight and we'll check the bus schedule in the morning. You do look very tired. Can you lean against this counter while I get your wheelchair?
(In the wheelchair) Is it far?
No, not far at all. And I think you are going to like it.
(Seeing the room) Oh! This looks just like my own room!
I thought you would like it!

He did not question why his pajamas were in this room. He still thought it was some foreign room, but he was happy.

I didn't try to convince him that there wasn't a bus station through our garage door. I did not try to convince him that he was already home. (Something I had tried to no avail many times in the past.) I didn't scold him for not using his walker. I did not point out that it wasn't his bedtime yet. I went along with him and got him what he wanted.

Of course this case was easy, because there was something specific he wanted and he was willing to tell me on his own. But if we'd stood there arguing about whether there was a bus station beyond the door or I'd tried distraction too early I might not have known that he just wanted to go to bed.

It can be very difficult to get into their mindset. Sometimes you just can't. Why does your loved one want to go to the train station? Are you sure she means the train station? Might she mean, oh, say, the beauty shop? Let her talk about what she wants and maybe the "why" will come out. Look for clues. Is she agitated about going, or is she eager in a happy way?

To look on the bright side, if it is the same delusion day after day, once you do get a good handle on how to treat it, you are home free!
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Mother gets delusional when she has UTIs check that first before any psyc meds.
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I remember my Mom asking me to call her mother to go visit, mind you my Mom was 98 at the time.... Mom actually thought she was in a hotel in Connecticut [the State she grew up in] instead of being in a long-term-care facility in another Sate, and that I had a room just down the hall.

I learned from this forum to say to Mom "maybe tomorrow" because I knew after an hour or so she would forget. The less words the better. Too many words or long drawn out narratives only confuse the person more.
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I hope a geriatric psychiatrist is involved in this situation. Seek answers from him or her. I have worked with people like your "loved one" and that's my best advice. There's an old saying I learned when I was a young nurse in psychiatric nursing. It goes like this: "the neurotic builds castles in the sky, the psychotic moves into the castles and the psychiatrist collects the rent." I said this to say - don't move into the castle with the person who has the delusions. Do your best to keep the person reality oriented but not to the point where it becomes argumentative. I pray you find the right answer to your very valid question. God bless you for trying to do the right thing!
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My Mom confuses TV and dreams with reality. Our Church puts the service on-line. She gets so "into it" she think she is there. What about buying DVD about train vacations thru Europe. This may satisfy him.
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I also wonder what the connection with trains might be. Is there a zoo near you, or any of the tourist trains? If so, you might take him on one of those. Zoos typically have trains and it would give him a change of pace to see the animals....unless you think that might cause confusion.

You can also play into the delusions and say you'll go in a few days (use the excuses as Malachy suggested - station's closed, under repair, something like that.

Whatever you do, don't deny that to him the delusions are real.
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Yeah. Take him to the train station. Geez I cannot drive due to seizures and ask my husband, who, unfortunately, is my driver, which is an issue for a different thread, to please let's stop at some car dealerships. He always says no. I'll be able to drive in six months and when i buy a car online I'll have it shipped to our address and that fee will be hefty boy howdy! Maybe he should have stopped at the car lots ???
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Just a thought. It's not unusual for me to dream about needing to take, or taking, a bus or train. I assume it's part of dream symbology, representing moving (or needing to move) in a new direction physically, mentally, emotionally, or even spiritually. Point being, the delusions might be similar to dreams. Perhaps looking behind the symbology of the delusions could help in dealing with them.
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Some good answers. The diversion is important but what I also do is ask questions: What do you remember about the train Station? Get them talking. A lot of time with my wife she says i am going to do a walk outside and what she is really wanting is to go the bathroom. I just have learned to be on my toes and not take statements literally and try to find the real meaning behind what they are saying. I really have to think out of the box when she talks now as words do not mean what she is trying to say.
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Some very good input on this so far, one thing to also consider is why he might be asking to go to the train station. Did he work for the rail system, did he take the train to work every day, did he have a childhood passion for trains?
If deflection to another topic does not work or does only for a few minutes, what about a good pictorial train book and have him look at that? Barnes and Noble usually has stuff like that around holidays.
Music has been showing good results. It reaches a part of the brain that is affected later in the disease. There may be music therapists in your area who can come to the house. There are two films that demonstrate this effect, All About Me (Glenn Campbell) and His Neighbor Phil (trailer at http://tinyurl.com/watchphil).
If these techniques don't work and he keeps asking, depending how frequent, if there is a station near, make an outing to go and maybe have lunch. May satisfy him for a few days.
Good luck.
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The key seems to be "divert". I have learned to NEVER argue ( even when what they are saying is ridiculous. ) And as a previous writer suggested, calming music. I can't tell you what a good effect music has on patient/s. It is a real miracle!!
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We have been using a psychiatrist to manage medications and have found this helpful. Sun downing delusions & visions have been reduced. Parinoia (belief that others are stealing) continues.

We also found with our initial medication review some Meds were causing problems and were withdrawn.
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Just say O.K. and try to do it.Sometimes,my husband would get into the car and see the sign for the station. I would say: See, here is the station.
He would say : Take me home now. I think the sick person is trying to tell us he wants to get away from the sickness. Other times, I would simply say: We can do that later.' The station is closed now. Track work'. One has to try to understand the desperate feelings underneath. I think it is very important to 'agree' with the feelings.Otherwise,pt. just gets angry,feels misunderstood.
So,agree..then be creative."Streets are flooded' or 'Closed today for cleaning...or repair work..' Put on some calming music..distract (TV).
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