Later Stage Dementia - Some Common Ground For Communication

My 88 year old mother has "unspecified" dementia.  She presents all of the classic Alzheimer's disease dementia characteristics.  Since January 2009, she has slipped quickly from someone who was having occasional memory problems, but could carry on a relevant conversation, to someone who now speaks about her delusions as though they are genuine, meaningful events.  She becomes fixated on certain delusions and they become serial topics for our daily visits.  These are "normal" conversations about an abnormal reality.  Still, I can have a quality conversation with her, if I just go along with her unrelenting delusions.  It is futile to address the delusions and explain that she is mistaken or misinformed.  I would have an equally useless experience reading a book and then trying to have a conversation with it.  Still, reading the book has value, and I've found the same to be true about listening to mom.  I'll explain what I mean by this, as you read further.

I've found that speaking in softer tones is more soothing and increases mom's ability to listen to me.  I've learned that I can redirect the conversation away from the delusional nonsense by introducing a new topic that mom can relate to, her past.  If I ask her about her family, the schools that she attended, her jobs, or some earlier times in her life, she enjoys talking about it.  Sure, I've heard many of these stories before, but we are communicating about something real instead of something absurd.  As a visitor, it is certainly more pleasant to discuss her past with her, because it makes sense.  There are many areas of her past that she can converse about intelligently and answer questions about.  She is still a reliable resource for some family history questions.  These conversations are therapeutic for the family member who thinks that mom is "gone".  She's still there and capable of carrying on a decent conversation even if she finds her current events fraught with confusion.

A good way to create "calm" for someone like my mom, is to provide some familiar, or at least pleasant, recorded music for her to listen to.  My mom, being Irish, grew up in a home that had her dad's orchestra coming over to practice occasionally.  I've found that the old Irish folk tunes are a real comfort to her.  She enjoys some swing music, also.  I've noticed that she likes to sing along with these old tunes.  It brings her a lot of joy and connects her to the parts of her memory that aren't mixed up.  Some gospel music strikes a happy chord in her, also.  The music is a good way to create a mood for talking about the past.

Since any visit will certainly involve some current events discussion, I prefer to listen to it at the end of my visit.  No matter how bizarre the conversation goes, it is wise to go along with it and appear interested.  At some point, you look at the clock (or your watch) and say something like "Oh my, look at the time, I really must be going now."  It's good to close with a comment about the good visit that you shared and when you will return for another.  It's always better to leave than to attempt to make sense of the delusional discussion and interact with it.  Why contribute to something that makes no sense?  Unless you are offering words of comfort as an appropriate response to a delusion, you are probably adding to the confusion.