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I Can't Get the Person with Dementia to Understand

Posted by on 5/19/2016
Here are a few common types of scenarios I might hear from caregivers:
  • Mom was upset because she had to get dinner on the table - even though she has not cooked in years.
  • Dad insists someone stole his wallet even though he no longer has one
  • Grandma changes the thermostat trying to get the temperature right, then complains it is broke because it is too hot (or cold)
Our first instinct will be to communicate in the way we typically do - tell mom she no longer needs to cook...dad that he no longer needs a wallet...and grandma that it is her own actions that is making it too cold or hot. In other words, we will reason with the person, using logic to try and show them why their way of thinking isn't right, such as:

"Don't you understand Mom? You don't need to worry about meals anymore; you have done enough cooking over the years. I will make supper - it is just you and I, after all, so we don't need much."

Whoa.

Did you just catch the irony of trying to reason with the people with dementia, trying to show them their way of thinking is not right? Of course, their way of thinking is not right! And with dementia, logic is lost on them. No amount of explaining will help the person understand the actual what, why, and how of a situation.



People with dementia lose insight to reality, forget events or may start to mix details, and become disoriented to time and place. Their complaints and worries come out of their current, mixed-up thinking - and that is the true reality to them. Perhaps this is what the mother in the example above is thinking:
My husband will soon be home for work, and then I know he and the children will all be hungry and ready to eat. I must get started now on preparations for our meal.

This was likely this mother's former routine and you can see why it would be important to her to get this task done. And you can see why she will likely not respond well when you tell her not to worry about it. In fact, this response might anger her or make her even more worried. Similarly, the dad may have been used to always carrying a wallet in the past so now when I can't find one, figures it must have been stolen. Grandma does not realize her moving the thermostat dial too much is causing the temperature fluctuations, so thinks it must be broken.

In all of these situations, the people with dementia do not understand the true reality that the caregivers see, but instead only understand THEIR REALITY that they see.

Trying to explain, reason, or argue with the person will not work. Instead try this approach:
  • Ask the person what is wrong, without any of your judgements or corrections
  • Validate the person's feelings! For example to the mother, you might say "Wow, you must be running late in getting dinner together and are worried about it. What can I do to help? Let's start some sandwiches." and then have the person help you.
  • Give a substitution or re-direction. For example, allow the dad to keep a wallet with a few dollars in it so he does not worry about having lost it. For grandma, cover her thermostat so she no longer sees in and tries to adjust it.

Above all, remember it is the disease and that the person's reality is different. Shifting your reference, expectations, and response can make a world of difference in how the person with dementia gets through these situations, making life better for both him/her and you.

Want more tips to help manage the symptoms of dementia that can lead to unwanted and negative behaviors? Access our Tipsheet below.

Get 10 Tips to Minimizing Behaviors
 
 
 
 

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