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Healthygirl01 Asked November 2022

Distraction or other techniques for worsening confusion of a dementia patient. Any advice?

I (and a staff of 3) have been caring for a 100 yr. old patient for a couple of years. She is so not the typical 100 yr. old. She is very well kept, sophisticated and financially endowed. Up until 2 yrs. ago she was driving, playing bridge, and on the go! Her confusion from dementia is worsening daily such that it is sometimes hours that she anguishes over the schedule (which we have simplified), and upcoming events. I have suggested to her 4 children that we eliminate the printed schedule so that she doesn’t hyper focus and obsess on “time” and “who will be here next,” etc. Additionally, since she has a large family there are always many events which are brought to her attention and then put on the schedule. They insist she stay busy and mentally engaged, that we drive her places, etc. It seems that she, as well as the adult children cannot accept that she is nearly 101 yrs. old! I have also suggested that we take her to her dr. so that she is prescribed something that will calm her agitation and anxiety down. Since my patient is still largely coherent and calls the shots, she will not have this. What do you suggest that we do since most of the staff ideas are shot down or disregarded? Her children are not the ones who are stuck every day at home for hours on end and trying to divert her attention to keep some peace. Any ideas are appreciated. Thank you!

JoAnn29 Nov 2022
What her family needs to know is how Dementia progresses.

In the beginning its short-term memory loss. So telling something one day is not going to be remembered the next day or even in the next minute. Processing is the next thing. You need to only tell her the minimum with no long explanations. They are still trying to process the first two words and your done the sentence.

Her anxiety is caused by expecting her to do what she is not capable of anymore. Not just because she is suffering from Dementia, but because she is 101 years old. Those suffering from Dementia get overwhelmed easily. My Mom was good for about an hour and then ready to go home. I agree, having a calendar with lots of activities is too much. Too many people visiting for too long is too much. More than one activity a day is too much.

Just because your client is sophisticated, doesn't mean she will not succumb to the disease like everyone else. Its like people saying their love one is highly intellegent. The brain is dying little by little. As each part dies, the person loses more of themselves. Sophistication and intelligence go out the door. She will forget who u are who her family is. She will be incontinent just like everyone else with the disease. Have paranoid moments and hallucinations. And go back to acting/being like a child who loves cartoons.

Fawnby Nov 2022
Healthygirl, yes, I get it! Been there, done that, still doing that. I wish you luck. Even without family support, the schedule could possibly be done away with. They wouldn’t have to know that, and you only have to tell her what she’ll understand. Which will be less and less. I admire you for taking the initiative to get this operation on a more workable level.

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againx100 Nov 2022
I go through the same thing with my mom regarding any scheduling of anything! She asks questions galore over and over. I've stopped giving her any info until the night before or mostly just the day of so that I won't have to answer the same questions 100 times.

I have stopped using the wall calendar except, as above, writing in the high level items that pertain to her, on that morning. Like "9 - Suzy Q" for the caregiver arriving.

Is she attending all these events from her big family? If not, they don't belong on her schedule.

There could be two schedules - one for her and one for the caregivers. Less information is better in this case (at least for my mom and that's how I do it). With her dementia increasing daily I assume that she is not in charge of the schedule or making plans herself, etc. I tell my mom - don't worry mom, I (or a caregiver) will tell you what's coming up and give you plenty of time to get ready.

Beekee Nov 2022
Turn on a children's channel on the TV. Find a program for preschoolers. Put old lady in front of it. Make a continuous 15-minute video recording of old lady enjoying TV for preschoolers. Show the video to the grown offspring.
Healthygirl01 Nov 2022
No, I think this is not helpful or reasonable for a woman of sophistication to watch cartoons. Also a little patronizing.
Fawnby Nov 2022
The children don’t have a realistic idea of what their mom needs now. How about a conference with all four and all staff present (but mom not there somehow), and possibly a doctor present? It’s like an intervention where they’re all
updated on what goes on. Keeping her engaged in things that she no
longer can comprehend, like the schedule, is an impossibility and what you describe is rising anxiety. That isn’t kind or fair to her. Also lots of people have the mistaken idea that if dementia patients are constantly entertained, kept busy and engaged, it will somehow stave off the dementia. That is just not true. Their brains are deteriorating and playing bingo doesn’t stop amyloid plaque buildup or make them suddenly calm and reasonable. I feel very sorry for the poor lady and for you. Please keep working on it until you all get some relief.
Healthygirl01 Nov 2022
Thank you kindly! You get it! I am also looking on the ALZ Association website for ideas. It will all be in vain unless there is strong family support.

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