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Patient continues to ask about spouse since she forgets you have told her that he died. How should you respond to her question so that you do not continue to revisit the grief of the death.

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Yesterday mom asked me where dad was. I told her he was in Heaven. She looked shocked and said, are you sure? I think she was referring to him not being with her anymore, not that he didn't go to heaven. I assured her that yes, he is in heaven and now it is my turn to care for her. She looked sad and shocked, but no tears and quickly changed the subject. I read different views on this. Some say to lie and say he is on a trip, at work, etc. With mom this would most certainly lead to more questions. The experts, as I said, have different views. Do we meet them where they are in the moment, do we not answer and redirect, do we lie- tell them they are with..... or have gone on a trip? Does it depend on the patients personality with how to respond? I know this will come up again.
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For one of my grandparents, they didn't really "cognitively" know their spouse was dead, until the entire family was at graveside, they finally broke down into massive tears & jolting in their wheelchair.
But everyone is different, and with dementia, it may not be possible to "cognate" (is that a word).
Once their mind is too far gone, all you can do is take care of their body, and how much you try to "explain" things is up to your current level of energy that day.
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I'm a terrible liar. When my dad keeps telling me that I need to feed mom, I get paralyzed. I remember what I read here about re-directing. That doesn't work. Actually makes him more agitated because I'm not following his lead. Remember, he's of the old school. He says jump, we jump. We don't question. We don't detour. So, I just have to remind him that mom died last year. Sometimes he remembers, and sometimes it's not registering in his head.
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i like yayas explanation. a pack of lies is a recipe for disaster and a permanent loss of trust. with the 2 dementia patients ive dealt with so far , truth has been my strength. im the only one who does give them consistant answers that add up. timing is everything tho. when they are lucid enough to ask the right questions, then is the time to give them the answer theyre looking for. other times you have to redirect and just gently add more reinforcement to what your trying to deliver to them. when aunt laments about her butchered thought process , i remind her that her brain IS 300 yrs old too.
a hospice aid suggested that to get mom to a phsyc i just lie to her then show up at a shrink office. i told her it doesnt work that way. it would destroy a trust that ive earned over 55 years and break the only link she had to reality and consistant facts.. idda gotten her to a shrink had she lived long enough but it takes time to nudge a demented brain. no regrets here. on her deathbed just before lights out time she blew the whistle hanging around her neck to summon me. she felt everyone else was blowing smoke up her ass. she died with our mutual trust intact.
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My parents were both in late-stage Alzheimers when my father died. They had to be separated a few months prior, because my dad had to go into skilled nursing. My father was cremated and since we are a very small family, we just had a private memorial service for him -- we didn't bother trying to invite many people. Yet we felt obliged to bring my mother to see my father that day before the cremation; after all, they had been married 50 years and were devoted to each other in the final years. She approached the coffin, glanced at him, then sat down beside it and muttered a few words. For one brief moment I think she knew what had happened, but I wasn't sure. A few minutes later we left the room and as we went out to the parking lot, my mother smiled a broad grin and said, "I want ice cream!" It was a very odd situation, because my brother and I were very solemn and sad, but we took her to an ice cream parlor and chatted about other breezy topics. For months after that day, my mother would ask for him, and I had to remind her that he was on a business trip.
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Just to play devil's advocate here - and I know this is the exception, not the rule - but there are times/circumstances when telling the patient...and yes, revisiting the grief...is the only solution. I just went through this with my MIL. She has been a widow for almost 17 years. Then one day she simply forgot, and began asking where her husband was. We tried to placate, reassure, redirect....sometimes it would ease her mind for a little while, but eventually more questions would crop up. If we told her he was fine, just gone to work, then she'd want to know how he got there. She knew he didn't have his license with him because she has his wallet. WHERE is he working? What's the name of the company? If we told her we'd talked with him on the phone (and he was ok) she wanted to know where he was, why hadn't he called HER, and when was he coming home. We found ourselves getting more and more entangled in a web of lies and false reassurances...it was like dancing on the edge of a sword. She wasn't buying any of it, and finally reached a point where she was so worried and agitated that she was preparing to call the state police and report him missing (this, after trying for four days to calm her down). At that point we knew we had no other choice - we HAD to tell her, because she wasn't going to let go. We located a copy of the death certificate because we knew she'd demand proof, waited for HER to bring up the question of his whereabouts again, and then as gently and kindly as we could, told her the truth. It was heart wrenching to watch her go through it, but in the end it worked. She told us through her tears that she understood, and she'd stop looking for him now.
I want to point out that MIL's form of dementia (Lewy Body Dementia) affects executive function more than memory, so unlike someone suffering with Alzheimer's she is able to grasp and retain the basic knowledge that her husband has passed. What she still keeps getting confused about is WHEN. She can't remember going to his funeral, but with prompting she can recall visiting his grave every Memorial Day to place flowers and a flag. She'll say she understands it all happened years ago, but still thinks she needs to make phone calls and let extended family members know. I like to use the "alphabet soup" analogy when describing MIL's memory loss.....some memories are lost, many still remain but they're all jumbled up at the bottom of the bowl. Dip the spoon in and you can manage to pull up a few, and she'll recall those individual memories...just can't quite put them in order any more. It's been five days since we had the talk with her and she's still grounded. We left the copy of the death certificate with her so she can keep looking at it....I realize that might sound cruel but in MIL's case she finds it comforting because it reminds her she doesn't have to worry about him any more. He isn't missing or lost.
Whatever the solution, it's a difficult and heart breaking issue, and my heart goes out to anyone finding themselves having to deal with it.
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My mother is also the last of her generation alive. All of her relatives are gone as well as most of her friends. When she ask about someone I usually say that I don't know and that I will call them when I get home. We did not tell my mother that my brother died this past November, we just say that he is in West Virginia. I have to aunts on my father's side who are still with us and like others have suggested here I to talk about happy times when we were all together. I mistakenly did tell my mother that her friend had died and after seeing her grieve all over again I promised myself never to do that again it is so sad to see....
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Why would you tell them at all? What does it accomplish except frustrate you and them.
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There are several ways to approach this. My mother asks about her mother from time to time. I think that it is due to a deep seated need to talk about her family. My dad once made the mistake of telling mom that grandma was dead and mom got incredibly agitated and panicky and hysterical. To cope with these questions, I have sent my grandmother on vacation with my aunt and uncle (also deceased) where they used to vacation all the time. I also send my grandmother to another favorite vacation spot of hers with her SIL. I make up family gossip and tell mom stuff like grandma and aunt went shopping and aunt bought a red and white polka dot dress (this actually did happen, so my stories are based on true past family stories!) I tell mom about phone calls with grandma - everything I say is happy and good news and grandma is fine and having a wonderful time. Mom believes ALL of this and it keeps her happy and unconcerned. Of course my grandmother died in 1976 and my Aunt and uncle died within the past decade. My mother is the last of her family to survive but doesn't know that. Mom was always very family oriented. One day we passed by a cemetery in the car and mom pointed to it and said "that is where mother is buried, poor little thing." (It actually was not the right cemetery, but on some level mom remembered for a minute there that her mom is deceased.) What you don't want to do is tell the person that the LO is dead because it is just like they heard the news for the first time ever and traumatizes them. When dad told her grandma was dead, she didn't believe him and said she had just seen her yesterday, then became distraught. Some people ask the elderly person who asks for their mother how old they are and if the elderly person knows their own age, then the unanswered question is answered in that way. But, with my mom, she is better off being told happy stories about family because it makes her feel safe and prevents agitation. I guess it depends on the specific patient. Now that mom is entering Stage 7, she goes around in the house calling for my grandmother. I think with most Alz/dementia patients, it is best NOT to upset them unduly. Otherwise it is like their LO just died all over again.
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You're right to not tell the person over and over that their spouse has died. If they've been told once that's enough.

Try redirecting the person, get their mind on something else. You might have to do this numerous times. Get them to look at a coffee table book of photos or turn on the tv to something they enjoy. If possible engage them in conversation about anything other than the spouse who died.

This is a common problem and I've seen this topic on this site a number of times. You can do a search here and see how other people have handled it.
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