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InWyoo Asked January 2014

How do you respond to a woman (92) in AL who has increasing dementia and keeps saying "I have no purpose in life anymore"?

She has been in assisted living for a little over a year and is currently recovering from a very recently broken hip (not nearly as severe as it could have been), and she now gets around with a walker. The facility she is in is the nicest here, and her family can easily afford it. She has been a friend of mine for several years, and I go to see her once a week. She always tells me, "I have no purpose in life." Before I got to know her well, she had been a social butterfly, plus conducted free self-empowerment workshops for many years. Now she surrounds herself with self-help books she brought with her to assisted living and studies them to see if she could conduct workshops at the facility. However, she can no longer accurately track conversations with even one visitor. And when visitors take turns reading aloud with her (one of her favorite things to do), she has been known to re-read the same page up to five times, unaware that she had just finished reading it. Yesterday she said, "I am sitting here waiting for something good to happen in my life." I replied, "While you are waiting, you could do what is in front of you." But she refuses to participate in 99% of the activities at the facility, saying they are not of interest to her or are too simple-minded. So what do I (and other of her friends) say when she laments, "I have no purpose in life anymore"?

EXPERT Carol Bradley Bursack, CDSGF Feb 2014
Even though her broken hip wasn't as bad as it could have been, a broken hip for someone that age is a tremendous trauma for the body. Also, hospitalization - even a brief one - can push someone on the verge of dementia deeper into the disease. Considering the physical and emotional traumas she’s suffered, her downturn is fairly normal.

I’d help her prepare for her workshops even if she does the same preparation steps repeatedly. If she has a goal, that is good and can bring her out of her slump for awhile. I wouldn't discourage her planning by saying that isn’t realistic. Planning may give her a purpose. You could even ask her if she has all of her supplies. Maybe a new planning notebook or something may help keep her interested.

Distraction by telling stories of friends and family can also help.
You are such a good friend. She’s a lucky woman.
Take care,
Carol

MIcheleBartlett Feb 2014
My mom says the same thing, AND she is terminally shy, can't start new relationships and so she keeps looking for people to reach out to HER. Maybe your friend could be encouraged to look for people who are hangers-back at some of the activities and start conversations with them for the purpose of "coaching" them with self-empowerment techniques. It matters little whether either one of them can track with the conversation for long; IMO it's about human-to-human interaction, whether or not any successful coaching (as opposed to workshops) actually takes place. She can also ask to start her own activities. We told the activities director at Mom's ALF that she was looking for opportunities to interact, as opposed to being led or where the AD is keeping up a stream of chatter, so she started a "Clip Coupons for Military Families" day (so the residents can visit while they do something PURPOSEFUL, instead of just making kindergarten crafts), and put a Scrabble game on a table in the "living room" to lure Mom out of her apartment. Also, is your friend on an anti-depressant? We were told that 90% of the residents at Mom's ALF are, and it could help. Blessings to you for being such a good, stick-by-her friend!

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joannes Feb 2014
My father went through this phase, and what I discovered that helped was to sit and talk with him about what he accomplished in life....how important he was as a father and what he 'gave' to my brother and I ....and then I just took it forward to my kids and their kids and how he went and helped the homeschooled with their math (he was an electrical engineer, computer programmer and mathematician....so his BRAIN was very important to him...and he dealt with knowing he had dementia for 8 years before it really got bad) I just pointed out that when you get to 90, and you've left a legacy of helping to shape all these young lives....and they will never forget you...then, it's OK to not remember some things, and to lose strength and to not be able to do everything you used to. Then I would talk about my Grandpa, who was in his 70s when I was born, and how important to me he was, but he had always been old, retired, sitting in rocking chair, reading the bible and smoking his pipe, while everyone took care of him....and yet, he shaped my life in many ways...while 'doing nothing'.....It was a great conversation with him, and he got tearful and admitted that the "really scary part being old, was just always wondering if your life had made any difference to anybody". At that point in time, he had already quit paying bills and turned over the trust and POA to me, because Mom couldn't do any of that stuff herself....and I assured him repeatedly that no matter what, I loved him and I would always try to do things remembering how he liked them done...and if he got too forgetful, I would help his mind with my mind, and that I would keep Mom safe and cared for too. Now, he's in a facility and he's past the point of caring. He wants to know he's loved and we are still coming to visit and occasionally he asks if he still has enough money in the bank and if Mom is doing ok. Sometimes he wants to go home, or he wants to know why he is not at home and why he has to be at 'this hotel'....and we just tell him he is staying where he is at because the doctor says he should be there while they try to keep his mind working as good as it can work. That is very satisfying to him....he's always wanted to do what the doctor suggested and he's always wanted his mind to stay in the best shape it could be in....so he says, "Oh OK....well, you know, my memory isn't what it used to be anymore...." and we just go to another topic.

dogtherapy Feb 2014
As long as we are here on earth, the Good Lord has a purpose for our lives. Just have her ask Him. It might be helping others, praying for others, being a friend, etc. God bless.

onedooropen Feb 2014
Can she help putting together baskets for abused women/children, knit blankets for babies in the hospital? there are church groups who do these things and would probably love to include her when they get together. My mother likes to stuff bears that a church group nearby her facility makes - cuddly toys for sick children. Did she have any hobbies/ play cards? maybe she could work on an outline of a workshop - develop something - she doesn't need to know it will never be finished and used.....

FuriousInCo Feb 2014
I particularly like MicheleBartlett's suggestion about clipping coupons for military families. Contrary to others who suggest confronting her with the inevitability of failure and uselessness, this woman needs to feel that she is still good for something. She's a human being and deserves to be treated as such.

Can she knit or crochet? Many organizations are looking for helpful hands to make baby blankets, chemo caps, shawls, and so forth. She can also teach those skills to others.

Does she remember what things were like during the Depression? The Foxfire books were written as a collaborative effort between students failing in school and elders. These students took interviews from older folks on how things were done back in the day. If she is articulate enough, perhaps she could make recordings of oral history. The local library or high school may be interested in helping with this.

The point is, she may be able to do any number of things with only a little help staying focused. Thank you for being concerned.

Adams017 Feb 2014
I would have to agree with all the other suggestions, that if you can, try to find a way to keep your friend busy and to help her feel like she has goals. The elderly just don't feel useful anymore.
My mom's life and attitude turned around 180 degrees when she was put on anti-depressants. It was a long road, bc she said she wasn't depressed. She sure was irritable and ugly, though! If your friend has family, and you can talk to them, maybe gently suggest that it might help if they talked with her doctor about prescribing some to her. You seem like an awesome friend!!

FedUpNow Feb 2014
I don't know if pets are allowed but if visits from dogs or cats that come in with their trained assistant might help (for 20 minutes at a time--not a pet left roaming through the facility) would be a day brightener and she could become involved in pet rescue efforts by cutting coupons for cat food or rescue supplies. Animals don't care if you repeat yourself hundreds of times. They just love you.

Eyerishlass Jan 2014
I'm assuming that with such a good friend as you and other people you referred to in your post you've all tried to convince her or to get her to see that she does have purpose in life but she is not convinced and keeps commenting on her lack of purpose in life. If this is so, trying to get her see that she has purpose is not working and probably won't work. However, you can talk to the activities director at the ALF and tell her/him how your friend is feeling, see if she/he can come up with someone special for your friend.

Since she has dementia she might be easily distracted. When she starts to talk about not having any purpose in life redirect her attention to something you saw on the news or a great book you're reading or something funny you heard. If your friend refuses to do anything about her situation or if dementia is preventing her from doing anything about it I'm sure it's very difficult to hear her talk about her lack of purpose all the time. Things like that can drive people away because we just don't know what to do or how to help.

As a last resort tell her to get over herself and go to the 'simple minded' activities. They're better than nothing, will get her out of the apartment, and I'll bet dollars to doughnuts that they'll make her feel better There's nothing more depressing than sitting around thinking about how depressed you are.

ferris1 Feb 2014
Let staff know what statements she is making so they can alert the doctor she is depressed. As a friend you can only support her, and recognize she is depressed and probably would do well on some medication, but that is for the doctor and her family to decide. The re-reading of papers, books is symptomatic of about stage 3 of dementia and there will come a time when she will be unable to read. So what if she re-reads things? She has dementia and others in her unit probably have it too and they don't mind. Try to look at her illness from her viewpoint. When you have lost your mind (thinking), that is pretty devastating. Keep visiting, until she doesn't recognize you, and visit still. You will not always have your friend, so cherish her while you do...

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