Live Their Reality

As a longtime professional caregiver to people with dementia, I learned many years ago, from a dear friend at the Alzheimer’s Association, three very simple but powerful words; Live Their Reality.

Research and experience has taught us that the mind of a person with Alzheimer’s tends to regress over time as the disease progresses.  Unlike the approach for certain psychiatric disorders, reorientation to reality is not a recommended method for a person with dementia or the neurological disease that we all know too well, Alzheimer’s.

Alzheimer’s disease cruelly destroys brain cells causing neurological tissue to degenerate.  One of the first areas of the brain to be affected is the hippocampus that is a storage area for newly formed memories.  As this area degenerates, newly formed memories are lost.  We may all be guilty of expecting the person with Alzheimer’s to recall something even when it is apparent he/she does not.  Why would we direct a person to the kitchen to retrieve us each a glass of orange juice when the refrigerator no longer exists? They will never find the orange juice.  Moreover, if we force a person to keep looking….well, let’s just say unless you keep the orange juice in the cupboard, you are both going to become very parched.

A resident I used to care for, Maggie, was a retired school teacher.  Some days she visited my office every 15 minutes or so and would anxiously say, “I have to leave.  I need to get back to my job, and I do not have a way to get there.”  Even on a Tuesday I would supportively reply, “Maggie, I would love for you to stay with us for dinner tonight.  It is Saturday, so we have plenty of time to get you back to the school by Monday.  I’ll make sure you get there.”  The sigh and look of relief were always instant.

Another resident, John, was a retired lawyer who was accustomed to having a secretary assist him in his work.  He would often mistake the caregiver for his secretary and tell her something like, “Please go file this paperwork,” as he would hand her imaginary papers that he thought were real.  The caregivers learned to accommodatingly “take the paperwork” and reply, “Yes, Mr. Smith, I’ll take care of it right away.”  He was always a gentleman whom we all agreed must have been a very respected boss in his day.

You can argue with a person with dementia all you want, but usually in the end, it will only cause stress and unresolved situations for everyone.  I encourage you to do as my friend has always advised me; step into their shoes and live their reality.  Hopefully, this will help new great memories, the reliving of those from the past, and the making of a less stressful, more rewarding present for you and the person you love with Alzheimer’s.

Is there a story you have about living the reality of the individual you care about with Alzheimer’s?