Coping with the Alternate Realities of Dementia Patients

Caregiver, patient expert

Whose Reality Is This?

Dorian Martin's SharePost about her mother's perception of the coming elections brought back powerful memories for me. Her mother had apparently heard some conversation about the 2008 election, and thought she and Dorian were on their way to vote, when in reality they were just going to the nursing home's common room.

This issue is one that needs to be addressed regularly. Most of us know, but we can easily forget that with dementia patients, it's generally easier for us - and healthier for them - if we just go with the flow, rather than try to explain "reality" to them. We have to remember that our reality is _our_reality. The dementia patients' reality is just as real to them. When we honestly think about it, each of us has a slightly different perception of reality than the person sitting right next to us. And that is, we presume, with fully functioning brains. So, why** wouldn't** a person with dementia think his or her reality is, well-real?

During my dad's decade of dementia, I never knew which reality he would be in, on any given day. Was he playing in Lawrence Welk's band? Was he a medical doctor? Was he waiting for his Ph.D. diploma to come in the mail?

My first order of business, each day, was to find out who my dad was. I was generally his office assistant, so my role was defined, if not easy. Once I talked with him a bit (assuming it was a day when he could communicate), I'd spring into action. Did he need a letter written to the mayor, or even the president? Did he need me to follow up one of his research projects he'd been asked to do? Did a general need to consult with him? Well, you get the idea.

I could have told him he was just imagining things. I could have reminded him that he was an old man in a nursing home, who'd had brain surgery, and that surgery had backfired, leaving him with dementia. But what good would that have done?

It would have made him feel diminished, if he believed me (or allowed himself to believe me). Or else, he would think I didn't want him to succeed. He'd think that I didn't want to help him.

This was during the time when his psychiatrist was insisting that I should be bringing Dad back to "reality." Sorry Doc. I was working with reality. Dad's reality.

Eventually, Dad got a new psychiatrist. One day, the doctor was looking at all the degrees and certificates hanging on the walls in Dad's room. At first, the doctor thought the medical "degree" was real. A nurse quickly straightened him out. He then asked me where I learned this technique.

I said simply, "I'm his daughter."

I learned kindness from my dad. He was an intellectual who'd had brain surgery, meant to correct a problem from a World War II brain injury. I don't believe the surgeon did anything wrong. However, probably because of old scar tissue combined with Dad's age, the result of the surgery was instant dementia.

I explained to the doctor that it would only frustrate Dad if I tried to drag him into my reality. The only reality Dad knew was in his head, and it was my job to go there; to join him in his reality and make that reality as pleasant for him as possible. I owed him no less than my best effort. This doctor nodded slowly, winked and continued on his rounds, while I got back to my work as Dad's office assistant.

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