A common contributor of stress to the family of those with a dementia diagnosis is the experience of disorientation to time and place. This disorientation often presents as a regression to times past. The caregivers and loved ones of those with dementia often struggle to deal with these inaccuracies, because correcting these thoughts leads to arguments or tears, but it feels dismissive or mean-spirited to lie. Consider the following example:
Dorothy, an 86 year old female with Alzheimer’s disease, has lived in a nursing facility for 9 years. Every day, between 4:30-5 PM she heads straight for the front door. She is certain that her husband Duke will be picking her up in his red pick-up truck and taking her straight home to prepare dinner. The staff is well aware that Dorothy’s husband passed away 10 years ago. How should they handle this behavior?
To those that have not worked with dementia patients, the obvious answer might be to delicately tell Dorothy that her husband passed away 10 years ago and she lives in the nursing home now. This may result in Dorothy becoming angry or upset, because in her mind her husband is alive and this is not her home. The nursing facility staff is aware that Dorothy’s husband used to pick her up from her job at the mill everyday in his red truck, then they would drive home and she would prepare their dinner. Therefore, staff could alternately say, “Dorothy, Duke called about 15 minutes ago and said he was held up at work and to eat without him. Now, why don’t we go have some supper and then we will come back up and wait for him.” The result of this interaction would hopefully be for Dorothy to go to the cafeteria, eat her dinner, and forget that she was waiting for Duke in the first place.
Redirecting, rather than correcting, disoriented thoughts and behavior is a way of meeting our loved ones where they are. Although it seems counterintuitive to fib, it does not serve the individual with dementia or their loved ones to argue over whose perception of reality is correct. Over time, redirecting and reframing becomes second nature as we recognize that we are contributing to a more calm and less anxious environment.