My mom has dementia and resides in a nursing home. She has very vivid ideas and thoughts about people, activities, and situations. She is totally convinced that these things are real. What is the best way to deal with this?
Answered by David Troxel
My mom has dementia and resides in a nursing home. She has very vivid ideas and thoughts about people (some real and some imagined), activities (like giving birth to several children who are being taken care of by others) and situations (she uses a wheelchair but “travels” to work, home and elsewhere outside all the time). She is totally convinced that these things are real, to the point where she is sometimes upset and angry. She feels no one believes her, which causes more agitation. At other times she can appear like her old self and be very lucid, engaged and funny. What is the best way to deal with this? I know not to constantly “reality test” her, but it can be difficult to communicate with her when she is convinced about so much that is not real. How can I make her more comfortable?
Delusions like these—fixed, false ideas—can come with the territory of dementia. I have met people who believe they have given birth; perhaps they are reliving memories from the past. My mother Dorothy used to create fantasies about other residents in her Memory Care community. One person was a retired general, another came from our old neighborhood, and so on.
I’m glad that you don’t “reality test” your mother. When she shares a delusion, don’t overreact or discourage her. Engage her about her story. Ask questions. I often asked my mom whether the general was a three- or a four-star general and how many awards had he won. Try saying “Tell me more about that” when your mom tells you about her office job. After you hear the details, you can follow up with, “Oh my goodness, you must have had a busy day at work!”
Keep your response simple and supportive. When she is upset and angry, try to provide hugs and comforting words. After she tells you about a problem, let her know you will investigate the situation.
All of us want to be heard, believed, and supported. Let your mom know you are listening and that you are on her side. Keep your sense of humor and do your best to help your mom feel safe, secure and valued. If you’re really concerned about her delusions, redirect her by starting a new project. Perhaps the two of you can create a scrapbook out of her life story and interests.
And remember, narratives like these are usually harmless. If they bother you, I would try to reframe the situation. Why not see her stories as something positive instead of negative? They are solid evidence that your mother’s imagination remains intact!