Responding to Confusion

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MINDY KIM-MILLER, MD, PhD
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Question:

I don’t know how to respond to my mother when she tells me she has been talking to her parents (deceased for 30 yrs) and they want her to come home. I try to explain that they are in heaven, happy and we will see them again someday. Sometimes that works, but other times she insists on trying to telephone them or wants me to take her to them. She also asks me when my mother died. I remind her that she is my mother and how happy I am that she is. She also often confuses me with other relatives. She seems to be becoming much more focused on those close to her who have passed on frequently asking who in our family is deceased. How should I respond?

–S.Z.

Answer:

Unfortunately, losing memories about family members is part of the cognitive loss that people with Alzheimer’s experience as the illness progresses. It is also common for those with dementia to become obsessed with certain subjects, such as death and deceased family members.

Depending on the stage of the disease, trying to reason with someone with Alzheimer’s can be futile and even cause agitation in the person. So you can try to reorient your mother to reality, but do not insist on correcting her incorrect beliefs or misperceptions if your efforts distress her.
One way to respond to such behavior is by using reassurance and distraction. As you are already doing, reassure your mother that things are fine and that she is loved. Then try to distract her with another topic or activity that she enjoys. Possibilities include playing music or a game, going for a walk, offering a snack, discussing topics in the news that can lead to reminiscing, looking at photos, or admiring something beautiful.
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If you cannot distract your mother from the subject of her deceased parents, you can ask her to tell you about her parents. Reminiscing can be comforting to those with dementia and a nice way to learn about their past. After you start a conversation about her parents, you can then transition to other memories and topics. If your mother insists on calling her parents, you can try playing out her confusion to a natural stopping point or transition point to another topic. For instance, when your mother wants to call her parents, you can dial your own telephone number to get a busy signal or no answer, then tell her that her parents are not answering, and that you can try calling them at a later time. Then offer to do something in the meantime as a distraction.

If she continues to request going to see her parents, you can try taking her for a walk or ride in the car to a familiar place (for example, a park, store, or a friend’s/relative’s house) or through a pleasant setting and see if you can distract her along the way or get her to enjoy the outing. You need to gauge whether these efforts might appease her or make things worse.
Keep in mind that some of these approaches will work on some days and not on others. You need to try different approaches to find one that works in that instance.

Dr. Mindy Kim-Miller is a trained medical physician who provides useful, but general answers to questions provided by online visitors. While Dr. Mindy can not provide specific medical advice or services, we hope you find her responses useful in your personal education. All information is provided for informational and educational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. If you suspect you have an illness or disease, or a health related condition of any kind, seek professional medical care with an appropriate health care professional immediately. Do not postpone or delay seeking treatment or disregard professional advice based upon the general answers provided by Dr. Mindy. Dr. Mindy’s advice is not intended to substitute for a visit to your personal physician or other qualified health provider. Any specific medical concerns or questions you may have should be directed to your personal physician or other qualified health provider.

 

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