How honest should I be with my mother about her dementia?


I've told Mom that I would never lie to her, but I feel the need to orient her because to agree with her only seems to add fuel to the fire.

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"Joe stole my wallet! I know he did! He is devious and evil."
"Look, dear, your wallet is under the afghan on the chair."
"Well Joe must have snuck in an put it there! I'm going to give him a piece of my mind."
"If Joe did take it, he must have had a change of heart, because nothing is missing. Do you think we can take the moral high ground and forgive him?"

Now if "dear" does confront Joe, it should not be a problem if Joe knows dear has dementia. And if a confrontation is likely, you might give Joe a heads up and explain that this paranoia is a phase of dementia.

My husband would go across the street and ask to use the neighbor's phone to call the sheriff, because "Jeanne is holding me against my will." All our neighbors knew the situation and they'd offer him a cup of coffee and a brownie and see that he crossed the street safely when he was ready to go home.

Those paranoid accusations can only do harm if the accused cannot be make to understand the circumstances.
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It is very hard to do, nebbish. We talk sometimes on the group about having a helmet so we can knock our head on the wall without it hurting. I also have a trusty finger pistol that I shoot myself with. Surprisingly, it helps with the stress. But somethings the craziness is still overwhelming. I walk away to my room and say all kinds of bad things. People sometimes say that I'll be richly rewarded in heaven, and I'll think not after the things I've thought and said. :-( I try to forgive myself, though, because I'm only a human dealing with a very difficult situation.
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I understand and accept the solutions offered. And thank you for them, because I see the logic behind them. And, of course, I will try to use them as I interact with Mom. I guess I just can't go along with her because then, I'm losing her to her imaginations and hallucinations. I always thought that Mom was in denial about her condition, but, I guess, it was I who was in denial. You're right....going along with her would be just so much easier than having the rifts that we have because, as she says, I don't believe her. This is going to be very difficult for me. But thank you, Jessie and Jean.
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Something I've noticed with my mother is that she notices something, then makes a story to explain it. nebbish, I wonder if your mother saw the screens in her closet, then put together a link in her mind that explained why they were there. After the story is invented, it becomes the new truth, so there is no point to try to correct it. What Jeanne said is right. You aren't going to be able to orient your mother to your reality. You just have to let it slide.

I would like to hear what people say about paranoid accusations. For example, what if someone said that a certain person stole their wallet and even finding it didn't help. That could cause damage. What would be a good way to handle that? I've not had to deal much with paranoia and accusations, so I really don't know how I would handle it.
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Hmmm ... I think the message you are giving you mother, the "truth" that she is hearing is that you don't believe her and you are not on her side. That wouldn't fit with my goal of supporting my loved one's quality of life, so I would handle it a little differently.

I have had that exact conversation about coffee with my mother. Answer, "OK. I'll get you a cup then." I would say, "Oh, Mom, I am so sorry for the mixup. How about you finish this lunch and then we'll go out for a scrumptious dessert." How about, "Great Mom! I'm glad you have your screens. Do you want me to put them in for you?"

What is the point of orienting her? Do you think she will learn from this? You understand that her brain is damaged and she is never going to get those brain cells back, right? So if you could convince her she did already have a cup of coffee, how would her life be better?

There are some really really hard situations to go along with or shrug off. A person with dementia accusing the spouse of infidelity comes to mind. But most of the small stuff is real easy to just go along with.

"Someone stole my wallet!" "Oh dear. I'm so sorry that dang wallet is missing again. I'll report it at the front desk, but first let me look around here, in case it just got displaced." How hard is that?

Think through what you want to achieve with your dear mother who has brain damage. Once you know your goal, it is easier to decide on actions.

But that is just my approach. Other here will offer you theirs.
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nebbish, there is really no winning, so you have to stand back and take a deep breath. Tell yourself that most of these things really don't matter anyway. It is mind bending, though, when reality is twisted and fabrications take over their lives.

Your mother sounds similar to mine in getting angry if I don't agree with the things she is saying or doing. My mother tells me often that her memory and mind are going bad. But I better not be the one to say it! She'll chew my face off. I usually let things go by unless they really matter. When I do say something, she gets angrier than most can imagine. She's mad at me right now because I wouldn't let her cut up a pair of socks for diabetics. I bought a few pair of these special socks for her and they were $30 a pair! I wasn't going to let her destroy them on a whim.

Most things don't matter, though. I just let the fabrications slide off my back. I do wonder what deep recesses of the mind these stories come from, and why they can remember the fabrications when they forget the real things.
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Mom is 93 and has been in her facility for three years now. She is paranoid to the point of thinking people are stealing from her; messing with her TV so that she thinks its broken; drinking her water; eating her food; taking her clothes. Recently she said that a woman was in her apartment when she came back from lunch and told her that she was there to return her window screens. Said she had had them for some time, but didn't know that they were hers until another lady said that they were, and so she brought them back. In all this and more, I remind her that...nobody has stolen her wallet cuz we always find it; she is the one who uses the shampoo and soap and towels in her one else; and the screens were in her closet because I saw them there. She is beginning to become really upset with me when I tell her these things. Says that I am making her worse than she is and putting words in her mouth. I called her twice to remind her that we would pick her up for lunch only to find her in the dining room eating her lunch and saying that she didn't know. Again, I try to orient her by telling her about my calls. When she was here for Easter, she wanted coffee...oh, I said, another cup? At which she began to admonish me and say that she didn't have any coffee yet and what was I trying to do? Those kinds of things.
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Your mother has dementia and is in an assisted living facility, right? How long has she been there? Is she well settled in?

Can you give us some example of situations where your concern about lying comes up?

Persons with dementia sometimes don't dwell in our reality. Telling them the literal truth in our reality may not ring true in their reality at all. So I think terms like "lying" or "the truth" have very slippery meanings when it comes to dealing with persons who have damaged brains.

By the time my first year of caring for my husband (LBD) ended I had a pretty clear caregiving goal. I could measure intended actions against that. I knew that dementia was a fatal condition and it would get worse. My goal was to enable the best quality of life possible for my husband until he died.

My struggle wasn't with "is it true?" but "will this enhance his quality of life? Is it kind? Is it compassionate?" In dealing with my husband, truth was not a primary consideration.

But if you can give us some examples, I'm sure other posters will share good insights with you.
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