Dementia Caregiving Strategies for Understanding and Coping with a Loved One’s Alternate Reality 

 

dementia caregivingWhy Does It Happen?

Dementia alters a person’s brain so that memories about recent events are forgotten or confused while memories about the more distant past often remain intact. This can cause the past to make more sense to a person with dementia than the present. A person’s alternate reality may be his or her way of making sense of the present through past memories.

What Lies Behind the Words Is Often More Important

People with dementia often have difficulty expressing themselves, and sometimes their alternate reality has more to do with a need or a particular feeling they are trying to express than it has to do with the words they are saying.

For example:

  • “When is my wife going to be home?” This question could be more about his need for affection or acceptance or a home cooked meal than it could be about wanting to see his wife, who died several years ago. A proper response to find out more could be, “Why do you want to see her?”
  • “I need to deliver all these pies to the neighbors by the end of the day.” Although these pies don’t exist, the words could indicate a need for a purpose in daily life or wanting to be involved in an activity. A proper response to find out more could be, “Why did you make pies for the neighbors?”

Keeping a journal of these types of events may help you to figure out trends in needs. For example:

  • Every time Dad asks for Mom, he feels better if prompted to recall memories of her.
  • Typically when Mary says she wants her mother, she is expressing anxiety about something that happened recently and wants comfort.

The more you listen and pay close attention, the easier it will become to understand the reasoning behind the alternate reality and how to best respond.

Should You Play Along?

As long as the situation will not be harmful or inappropriate, it is ok to play along with your loved one’s alternate reality. Doing so will not make the dementia worse. Remember, your loved one’s reality is true to him or her and playing along can make your loved one feel better.

For example: If your loved one is convinced he is a great musician in a band and the year is 1958, it does no harm to let him believe so and perhaps let him practice his performance for you or others.

If the situation is inappropriate or may cause harm to your loved one, try to respond to the perceived need while redirecting your loved one to something less harmful or more appropriate.

For example: If your loved one wants the keys to drive the car and she is no longer able to drive safely, it may be because she wants to get out of the house. A response to try might be, “It is such a lovely day outside. How about we go for a walk after lunch instead?”

Keep in mind these three steps:

  1. Reassure the person.
  2. Respond to the need.
  3. Redirect if needed.

Additionally, call on the professional home care services of At Home Independent Living. Our caregivers are trained in caring for individuals with dementia and can provide respite care services for family caregivers who need some time to refresh and recharge.

Click here to download a printable PDF version of this page.

Sources: Alzheimer’s Association, Dementia Care Central, Social Care Institute for Excellence, Daily Caring

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