We’ve been working with a gentleman who recently began worrying in the afternoon that he needed to get to his job, and that he had a ton of things he needed to do that day. Sound familiar? This sort of behavior can be awfully difficult to redirect, since he is focused on the tasks he believes he needs to accomplish. And, it is compounded with the notion that he spent all day playing games and needs to play catch-up.
If you’ve been working with dementia, I’m sure you’ve heard that often a person’s thinking reverts to an earlier period in their life. Hopefully, it was a nice period that they feel comfortable in. Sometimes, if a person’s early life was rather difficult, this symptom of dementia can be hard to live with.
In trying to help our gentleman we employ a few different strategies. First, we try reassurance. I tell him that he had the day off or that all his work is taken care of. We also try to pre-empt his sudden realization he should be at work by playing cards or dice games beforehand. Inevitably, he looks at his watch and sees the day is almost over and starts to worry. So, we may try to redirect him with an activity or take him on a walk to the restroom to take his mind off of it. Usually between these methods we could keep him stable.
Of course, as his dementia progressed, his illusions became more pronounced. He began asking about his car and where his car is. He would go out to the window and try to see if his car was there. We would tell him that his son dropped him off today and will be back to get him soon. His reply usually was, “My son’s got my car!” with a really alarming tone. So, we try to reassure him that his son was here this morning and everything is taken care of.
Now, it wasn’t until recently that I wondered what he was thinking when we told him his son had his car. If, his mind has reverted to a time when he was younger, wouldn’t his idea of how old his sons are be influenced as well?
Today, I asked him during his episode about his sons. I asked, “By the way, how old are your sons?”
“They’re just teenagers,” he said.
If you hadn’t guessed, our gentleman is in his 80’s, and his sons are 50+ years of age with children and grandchildren of their own.
No wonder he would get so upset when we told him his son has his car and will be picking him up soon. He probably thinks his teenage son swiped the car out from under his nose and left him there!
So, we’ll be trying new strategies to reassure him. Strategies that don’t have to do with his family. Maybe we’ll tell him his car is in the shop. Maybe, instead of his son picking him up, we’ll tell him his brother will be here.
Small details make a big difference when working with your dementia clients. Understanding how they see the world can help you avoid accidentally saying the ‘wrong’ thing!
