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when to help orient
Posted: Friday, November 15, 2019 8:08 PM
Joined: 11/15/2019
Posts: 3

My mother is becoming more disoriented.  She has difficulty differentiating what she has dreamed with reality.  She recently thought that the men who often inhabit her kitchen had taken me hostage and possibly killed me. I'd like to hear some thoughts on how to decide when to give her reality checks and when to let things slide.  Her delusions are often frightening and sad.  The dismissive things that you occasionally see getting passed around on the internet about not arguing with dementia patients or to "just agree" with them are not helpful, but incredibly trivializing.  This is hard stuff and me and my siblings really have no idea what we're doing.
Posted: Sunday, November 17, 2019 1:00 PM
Joined: 1/28/2013
Posts: 2647

In my early days on this board, seven years ago, I heard a lot about validation and just agreeing with what you LO says and believes.  I did some independent research and learned that orientation therapy is just as successful as validation in terms of patient comfort.  I then chose a happy medium which consisted of validating the emotions behind a belief but not reinforcing a negative or frightening delusion.  I would not agree with my mother that there were hostile intruders in the house.  The main thing is to reassure her that both you and she are safe and you are keeping it that way.

There are other hard questions like when can I go home or where are my parents?  For those sad ones you either redirect -- tell me about your home, Mom,  what is it like?  Or fudge a little -- your mother and father can't come right now but you'll be seeing them soon.  I can see you love them very much.  Tell me about them.  The important thing is to be kind.  My own mother had some tragedies in her life that it would have been a mercy if she forgot, so those things I let lie unless she brought them up.  If she did, I agreed it was a sad time but we all made it thtough and here we are.

King Boo
Posted: Sunday, November 17, 2019 1:19 PM
Joined: 1/9/2012
Posts: 3260

The disturbing nature of her delusions are making her days horrible.  It's one thing when the delusions are the kittens playing in the kitchen; another when they become dark and disturbed.

Time to find a Geriatric Psychiatrist who works with dementia.  Medications may be indictated to help with these.  Not from a GP - a Geriatric Psychiatrist MD

Posted: Sunday, November 17, 2019 3:23 PM
Joined: 2/3/2018
Posts: 759

Super second both the recommendations you've gotten from Unforgiven and King here. Especially the geri psych doctor. I believe every family caregiver should insist on one being referred to their dementia loved one's care team. My mom's geri psych doctor has been INVALUABLE in helping us help Mom in the worst of dementia's manifestations with thoughtful prescribing of medications. Not sedating her, not overprescribing, and they don't take all the bad stuff away but gives your loved one, and you as the caregiver, some relief.

I'll add that our mom isn't very verbal anymore but she does often throw out a jumble of words that I can hear the concern or fear in her voice, instead of correcting or agreeing with her I'll just try and empathize that her concerns are valid, something like "That sounds like it's upsetting you, Mom. That would upset me too. We'll take care of it together, okay?" Going that route might be helpful to add to your bag of caregiver tricks too.

Good luck to you both, chelejf!

Posted: Sunday, November 17, 2019 4:53 PM
Joined: 7/12/2017
Posts: 1607

Is she on any meds?  My mom did worse with meds she was just a mess with weird twisted mixed up memories, it was lke they are triggering some real memories, throwing in some tv show or the news and it was awful.  That being said, meds can do wonders,,, just be prepared to have to do a bit of trying this or that

That could be whats going on, if you can so, oh wow, that was a really scary dream!!

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