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sonswife Asked April 2013

Kindness or correction?

Saturday my sister-in-law left a phone message saying her mother was upset and crying (and could we go visit her). They had spoken on the phone and my sil corrected my mother-in-law's confusion about a family member coming to visit her that day. The family member had visited the previous weekend. My sil said in her phone message that she "had to burst her bubble", telling her mother the relative wasn't coming to visit. My mother-in-law was disappointed that she wouldn't have the expected visitors and upset about her confusion. Without correction she would have been disappointed when her expected guests didn't arrive or she may have eventually forgotten she expected visitors. Wouldn't it have been kinder to not correct? Any suggestions on resources on communicating with mildly confused elders?

KatZen Apr 2013
ChristinaW, true you may never know the truth of those stories but they are a wonder to behold. I agree we have to come back to our reality, but the chance to share can be a gift in itself.

ChristinaW Apr 2013
KatZen, I meant to add we need to remember to come back to our own reality when dealing with others, especially those not familiar with the weirdness of caregiving.
Some acquaintances never believe the stories related. I have gotten a lot of funny looks and head-nodding.
A few things my Mother told me before she stopped talking last year I will never know the truth of. Oh well, we each have our own stories:) xo

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KatZen Apr 2013
I agree fully and joined my mother in her "reality" and it just drove my family nuts. I wrote those stories then down for my genealogy books. Yes, I heard them 100 times but it was the Alzheimer's. I think you have to develop a little Zen to go with this disease. Ask them about their childhood and write down the stories while you can, they will be gone soon. Ask all of your questions about the past, the 60's, Vietnam, Korea, WWII, 50's, the Red Scare, bring the history of the past to life. I wish I had with my grandparents, especially after I got a hold of there pictures of when they first got together. My favorite, both of them standing together each with a bottle of beer, root beer (?) in front of a tent in the town where her father was buried about three months before they were married. I wish I knew that story. Ease their anxiety and confusion by joining their world and wonder at what you will find.

ChristinaW Apr 2013
I agree with not correcting and joining them in their "reality." When we were expecting a rare visitor when I had my Mother with me, I would tell her and it was something to look forward to. If we got a call at the last minute they weren't coming, not only was my Mother disappointed, but I felt like an idiot for building it up. After learning that lesson, I did not tell her anyone was coming until I saw them drive up to the house.
Try to get everyone on the same page. It's about reassuring your mil to ease her anxiety or confusion, and the others should adapt.

caregiverforum1 Apr 2013
I don't see validation as lying and find it curious that more than one person does. It's an acknowledgement of their feelings and what they're experiencing. I don't think it should be used in every case, but I also don't think there's usually a need to be blunt or mean or constantly correcting or reminding them that they're repeating themselves. As a commenter on Schuster's article notes, "When they can no longer join us in our world, we must join them in theirs." I love the gentle correction of saying yes, we're going out, but not for a few hours. All this said, we'v been very blunt with my mother about her living situation because she doesn't remember the falls, hospitalizations, admonitions of local law enforcement, etc. But the bluntness doesn't even really work. When we tell her about her medical history, she thinks we're making it up....

SuziQ Apr 2013
I also agree. But I have a hard time playing along. I was taught not to lie, to tell the truth and don't fib. And here is my mother doing exactly the same thing. I'm afraid there will be some kind of consequences. It would come back and bite me in the butt. Like when I was young/er. I'm learning to let it go, but it's so hard. I guess I want her to know the truth when she tells me a story and uses some else's name or place so the next time she tells the story, she will use the right name or place. But she doesn't.

jeannegibbs Apr 2013
Correcting or "bursting their bubble" is seldom the best alternative, and when it is necessary it needs to be done respectfully and carefully.

When my sister found Mom up and dressed at 4 am, waiting to come to my house, she said, "I'm sorry we must of gotten our signals crossed when we talked about this last night. We are defineitely going today, but not for another 3 hours. Would you like to lie down on the couch here, or go back to bed for a few hours?"

The issue here is not just an answer to you, but somehow educating the rest of the family. The article lschuster827 suggests is a good starting place. There are lots of posts on here discussing the issue of "lying" or "creative fibbing" or "validation" as a kindness for dementia patients. You need to be respectful of your sister's good intentions and somehow share with her the insights you already have.

Good luck!

jlschuster827 Apr 2013
Just want to agree with previous comment about the usefulness of the Validation Technique. I had the fortune to interview its creator, Naomi Feil, and wrote about it last week in The Washington Post. Some of the strategies and tips she recommends may be useful in this situation. They were most helpful for mine

caregiverforum1 Apr 2013
You might want to check out the book "Validation Techniques for Dementia Care" by VIcki de Klerk-Rubin or "The Validation Breakthrough" by Naomi Feil. They promote a compassionate, empathetic approach to improve communication with people with dementia. The techniques give caregivers ways to respond kindly to someone's mistaken thoughts.

wendala128 Apr 2013
I had a client who would insist that her husband's nephew had not been to see her since she moved, and he would visit at least twice a year...she would never remember from one time to the next. It got to the point where it was not worth upsetting her to disagree, so I would nod my head and agree with what she said.
It is always a fine line we walk...I also found that keeping a daily log book of visitors and appointments would help keep my client in the here and now. Even with that, you may find an argument...sometimes you can't win!

ellantz Apr 2013
I agree, that it would have been kinder not to "correct".
This I've learned (painfully) from the past 3 years of caring for my 93 and 95 year old parents, both of whom have dementia. Like any relationship with loved ones, you need to pick your battles, and the one you described above sounds like it escalated way out of control.
Dealing with even mildly confused folks takes a great deal of self control; before visiting or speaking with them, I have to take on a stoic mindset, in which I primarily just listen, and assure them that everything is fine - everyone is doing well. Do not give details, particularly negative ones. I NEVER correct or contradict - but repeat the mantra that everything is fine.
All of this takes practice, practice, practice, and occasionally I have slipped up,and gotten sucked into the craziness but it just re-enforces my will to do better next time.
Sounds like you are in the possibly early stages of this, and your MIL will NOT get better - only you and the people around her can make it better (tolerable) by your behaviors.
As for resources, I would strongly suggest doing Internet searches on this issue. There is lots of info that you can adapt to your situation.
Good luck to you!

mission2005 Apr 2013
My mother and my FIL both have dementia. We find it best to let them know that a guest MAY be coming in a few days They will, in most cases, forget in a short while but if they are expecting a visitor on that day they seem to stay upset they haven't arrived all day..

balexander9 Apr 2013
It is probably better to tell her that the visitors will be coming "soon" but not right away if they are going to be visiting at some point. She may forget about it later or, if she does remember, she might be less anxious about the fact that it isn't today.

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