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Psychologist shares beautiful advice for talking to people with dementia

"This isn't 'playing along to pacify the old guy,' this is an opportunity..."

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Dr. David McPhee offers advice for talking to someone living in a different time in their head.

Few things are more difficult than watching a loved one's grip on reality slipping away. Dementia can be brutal for families and caregivers, and knowing how to handle the various stages can be tricky to figure out.

The Alzheimer's Association offers tips for communicating in the early, middle and late stages of the disease, as dementia manifests differently as the disease progresses. The Family Caregiver Alliance also offers advice for talking to someone with various forms and phases of dementia. Some communication tips deal with confusion, agitation and other challenging behaviors that can come along with losing one's memory, and those tips are incredibly important. But what about when the person is seemingly living in a different time, immersed in their memories of the past, unaware of what has happened since then?

Psychologist David McPhee shared some advice with a person on Quora who asked, "How do I answer my dad with dementia when he talks about his mom and dad being alive? Do I go along with it or tell him they have passed away?"

McPhee wrote:

"Enter into his reality and enjoy it. He doesn't need to be 'oriented.' Thank God the days are gone when people with advanced dementia were tortured by huge calendars and reminder signs and loved ones were urged to 'orient' them to some boring current 'reality.'

If dad spends most of his time in 1959, sit with him. Ask questions he didn't have time for before. Ask about people long dead, but alive to him, learn, celebrate your heritage. His parents are alive to him. Learn more about your grandparents. If he tells the same story over and over, appreciate it as if it's music, and you keep coming back to the beautiful refrain.

This isn't 'playing along to pacify the old guy,' this is an opportunity to communicate and treasure memories real but out of time."

People on Quora loved the thoughtful, compassionate advice. Many people shared that they had taken this approach with their relatives with good results, and people who work with dementia patients confirmed it also. Some said that "orienting" to present reality may be helpful for people in the early stages of dementia, but not necessarily in the middle or later stages.

Of course, caregivers know that dementia means more than simply living in another time period in your head, and that talking with a person with dementia might require different skills and approaches on different days. But this advice to learn about a loved one's past may come in handy for family members who feel sad or hurt that they aren't being remembered in the present. It may help to see it as an opportunity to time travel with the person rather than a loss. When a person is deep in their long-term memory, you may be surprised and delighted by what you can discover.

People with dementia don't need to be brought back to the present if it's just going to confuse or irritate them. If they are in a safe place and are being watched over so they don't wander or do something dangerous, let them be. Join them in their past world and get to know them in a way you may not have had the opportunity to otherwise.

Solid advice, Dr. McPhee. Thank you for sharing it publicly.


This article originally appeared on 10.15.21

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Health

Relax, it's probably not dementia. Watch this poignant video that explains the difference.

Forgetfulness doesn't always mean dementia.

Photo by Robina Weermeijer on Unsplash

It's probably not dementia.

If you’re anything like most overwhelmed adults, you may sometimes find yourself forgetting why you walked into a room. Perhaps you've wondered if it's an early sign of dementia. You let the thought flow while knowing you’re likely too young … but what about early onset dementia, you might think to yourself? If you've had this thought more than once, watch this video as it ought to put your mind at ease. Teepa Snow from Positive Approach to Care (PAC) demonstrates the difference between normal forgetfulness and dementia (a general term for a variety of conditions, one of which is Alzheimer's disease).

In the video, Snow sits in a chair and thinks out loud that she would like to make a cup of coffee but on her way to do so, her phone rings. The conversation involves several details and by the time she hangs up, she’s forgotten why she was standing up in the first place. It’s an occurrence that probably happens multiple times a day in most households. You start to do something and get distracted by a pet, child or phone call, then completely forget what you were going to do in the first place. The feeling is frustrating, but sometimes it turns into concern, especially if it happens multiple times a week.

Snow effectively demonstrates how dementia differs from forgetfulness and the contrast is mind-blowing. When Snow sits back in the chair to set the stage for the dementia example, the audience appears shocked by the notable difference. She gets up to make coffee, answers the phone then begins rambling about someone stealing her drinking glasses before tucking it away safely in the freezer. Yes, the freezer.

The stark contrast between average forgetfulness and dementia is so effectively displayed that it should ease the minds of many overworked and overly stressed people.

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Family

15-year-old boy created an app to help his grandmother with dementia. Now it's free for all.

As the African proverb says, "It takes a village to raise a child." It also takes a village to care for an elderly person with dementia as well.

Caring for someone with dementia usually requires a team of in-home caregivers, outside healthcare workers, and family members. The patient must be under constant supervision, take multiple medications, be fed, have their hygienic needs met, and be driven to and from doctor visits.

All the while, the patient needs to be given the opportunity to spend the rest of their days as happy and comfortable as possible.

Nineteen-year-old Logan Wells of Lexington, Massachusetts, found an amazing way to organize the village of people helping his grandmother Nannie who suffers from dementia. With the help of his father, Eric, he created an app to keep all of his grandmother's caregivers on the same page, in real-time.

"When we first started," Hallie Nannie's daughter, told Colonial Times Magazine, "there were pieces of paper all over Nannie's house: the chore chart on the fridge, the calendar on the kitchen counter, the medication check-off."

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Then, as Nannie's condition progressed, she needed more caregivers, making things even more difficult to manage.

"It became really hard to stay on the same page, because we had to have multiple group chats," Logan told Best Life.

So then-15-year-old Logan got the idea for the app that would be come CareZare. "I learned the coding and my dad helped me create the prototype, and then we contacted a father-son duo to help us with the development," he said.

Over two-years, they developed the app to include heads-up alerts, like for the time when Nannie's clothes washer broke and a plumber was needed.

The app also has a calendar feature , which is great for keeping track of regular doctor visits. It also has a daily journal feature where caregivers can recount their time spent with Nannie and le t everyone know how she's feeling.

According to Logan, when caregivers start their shift, they can "look at the app and read the recent journal entries and heads up alerts, so if there's anything significant, they can deal with that."

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Seeing how well the app worked for their village of caregivers, they thought it would be a big help for others as well.

"We started to think – we can build this so it's useful to other people," said Eric. "We felt there were opportunities to really promote team-based care at the family level,"

Now, caregivers everywhere can download the app in the Apple or Android store and use it for free. It's also available to organizations for a fee.

"CareZare allows caregivers to take a team-based approach to care-giving instead of going it alone. Involve other family, friends and outside professional services on a single platform for ease of communication and better care," the CareZare website reads.

It may take a village to care for someone with dementia, but it's a lot easier when the caregivers are connected.





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Heroes

Bill Gates' family has a history of Alzheimer's. He's doing something about it.

For Bill Gates, changing the way we diagnose and treat Alzheimer's is personal.

"Several of the men in my family have this disease," he said. "And so, you know, I've seen how tough it is. That's not my sole motivation, but it certainly drew me in."

John Lamparski/Getty Images.

It's that motivation that prompted Gates to announce a $30 million initiative with the Alzheimer's Drug Discovery Foundation, which aims to create a revolutionary new way to test and identify the disease.

"The things I've seen over the last seven months make me more hopeful than ever," he said.

Right now, diagnosing Alzheimer's can be slow and expensive. Gates wants to change that.

Getting diagnosed means going through a series of complicated tests before other possibilities can effectively be ruled out. That means potential research and treatment options are often missed because people aren't diagnosed until their symptoms are already manifesting in their daily lives.

"We need a better way of diagnosing Alzheimer's — like a simple blood test or eye exam — before we're able to slow the progression of the disease," Gates wrote in an announcement.

"Imagine a world where diagnosing Alzheimer's disease is as simple as getting your blood tested during your annual physical."

In November 2017, Gates first announced a separate $50 million initiative toward curing dementia and Alzheimer's through the Dementia Discovery Fund. After that, he said he was moved by the responses from others, which made him want to open up about his own family experiences and to get even more involved.

"Because my family didn't talk publicly about my dad's diagnosis before the announcement, I had yet to experience how remarkable the support community is," he wrote.

Creating a simple, cost-effective way of diagnosing Alzheimer's could be a valuable step toward a cure.

And by putting his name and story behind this new diagnostic venture, Gates is giving new promise to those affected by this devastating illness.

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