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Arguments |
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"He tells me he wants to go home. We�ve lived here for 35 years, and when I try to explain to him, he gets mad at me." "I�ve told her time and time again not to put things in the waste basket, but she doesn�t listen." My Dad asks, "Why don�t the buses run by here anymore?" or "How far is it to the river?" When I tell him it�s 3000 miles to the river he gets mad, and says I am a fool. He thinks he�s in Cleveland. He hasn�t been there in 50 years. We have a hard time letting go of the old habit of reasoning with our spouse, parent or friend who has been moved beyond reason by dementing illness. It is important to keep in mind that real deterioration of brain tissue is the cause of apparently irrational behavior. The victim is not behaving this way to annoy or irritate. In fact, they are probably unable to consider the impact of their actions on others. It is seldom going to work to "teach" the woman not to hide things in the waste basket. Instead, we must teach the caregiver to accept this behavior as harmless and to check the waste baskets before emptying them. The woman whose husband wanted to go home learned that she only frustrated both of them when she tried to "explain" that they were at home. Rather, what worked was to go outside and walk to the corner and back. Upon entering the house a few minutes later, her husband was content. His short term memory was poor, and he would ask the same question again later, but there is an important lesson here; there is no reason why the patient�s reality must conform to ours. If Dad thinks he is in Cleveland, what is the harm in that? If an Alzheimer�s patient expresses a request that is obviously impossible, we may be tempted to respond with a reasonable explanation of why it cannot be done. A caregiver told me of the time her husband woke at one in the morning and wanted to go to San Francisco. Rather than explaining to him all the reasons why it wasn�t a good idea, she said, "All right, but we�ll have to get dressed first." And ten minutes into this process she suggested having some ice cream and then watching television, and then going to bed. His poor short-term memory allowed her to redirect him. No one underestimates the stress of being awakened at 1 a.m. and kept up for 40 minutes, but it could have been worse if the patient had become agitated in an argument about the appropriateness of a visit to the city. It sometimes helps to become a co-conspirator. Perhaps you have hidden the keys to the car and Dad wants them. Or you�ve come to visit Mom and she accuses you of taking the checkbook she mislaid. Instead of responding to the real situation, why he can�t drive or Mom�s history of losing things and the hurt of accusations, we might agree that the items are lost and offer to help look for them. After looking for a bit, suggest that "well, we�ll find them, but let�s sort clothes right now. We really need to get this done." Wait for an opportunity to redirect, and always talk positively about the future. "It�s going to be all right." Remember, you can never win an argument with an Alzheimer�s patient. Courtesy, Caregiver Newsletter of the Duke Family Support Program, East Central Illinois Chapter In the Northern Virginia Chapter Service Area, for more information about Arguments, please contact the Chapter's telephone Helpline at 703-359-4440 or 800-207-8679. Outside Northern Virginia, please contact your local Chapter.
Last updated: March 1, 1999
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