Meeting Someone with Dementia in their Reality

[Updated: 24th March 2017]

We previously wrote about why people with dementia lose memory and how this changes how they experience the world and their life.

How to Deal with Confusion and Requests

In the majority of cases, going along with or entering the reality of a person with dementia, rather than contradicting or lying to the person, will minimise upset and disorientation.

For example, the person with dementia might think that they are still supposed to be at work or they might be asking where their mother is (who may have passed away years ago).

In general, contradicting the person or telling them they are wrong tends to cause more anxiety, confusion and arguments for everyone involved. If a person with dementia is saying, “I want to go home”, trying to convince them that they are in fact at home will often cause more distress because that is not what they believe.

On top of forgetting things, it is can be difficult for a person with dementia to use logic, reason and rationalise things.

Even if what you say in response is fact and reasonable, it will often not work. It does depend on the individual and some people may be perfectly happy to accept what you are saying and you may be able to re-orientate that person, especially in the early stages of dementia.

It is recommended to not lie to the person with dementia.

If they are asking for their mother and you respond by saying, “Oh yes, she will be here later”, then you are not dealing with the underlying issue and the person will still be waiting for their mother.

The memory of a person with dementia can fluctuate. If they remember that their mother has passed away and you have just told them that she will be here later, the person is likely to get confused, upset or angry and they may trust you less.

How to Understand What a Person with Dementia Really Means

Usually, it is best to understand what the underlying emotion/feeling behind what the person is saying is and give reassurance based on that.

For example, if someone is asking to go home, the underlying emotion may be that they do not feel safe or comfortable where they are. They need to feel safe, rather than literally wanting to go home. So, you may want to give reassurance that they are safe and make sure they are comfortable, rather than try to persuade them that they are at home.

If someone is asking for their mother, they may be feeling anxious and need to be comforted. You can then reassure them saying, “Well, I’m here for you, is there anything I can do?” and maybe giving them a hug, rather than telling them that their mother has passed away.

Ask About What a Person with Dementia is Remembering

The next step would be to go on and talk about the person or place that they are asking for. Once you have given some reassurance, go on and talk about the mother or about what home was like. This way, you are acknowledging what the person is saying and not just dismissing it and changing the subject. You are also more likely to get to the bottom of what exactly is making the person feel unsettled.

By talking about their home, asking what they would be doing at home right now, you might find out that you can do that activity with the person now. If they think someone is waiting for them at home, you can give reassurance based on that.

Sometimes, by talking about the topic, the person will remember things themselves and re-orientate themselves to where they are now. Often, the conversation will then naturally move on to something else, and the person will forget that they were asking where the mum is.

Avoid or Relieve Their Anxiety

As a carer it can be difficult to do the above as you may want your relative to be in our widely accepted, shared reality and for them to know what is going on now. With dementia, it is very important to avoid or relieve anxiety by not contradicting the person. Imagine someone trying to persuade you of something you do not believe. You will probably feel very confused, worried, irritated and lose trust, just like a person living with dementia.

How it Helps

By acknowledging the fears and anxieties of a person with a dementia are a result of their need to feel safe and secure and have a purpose (just like all of us), we can understand:

  1. the importance of knowing a person’s life history
  2. how their life history can be used to appreciate how they the see, hear and feel life and the world when living with dementia
  3. how a person’s life history can be used to enter their world so we can better relate to them, support them and they feel safe and supported.

As people who know the person the most, family carers have an important role in keeping the person feeling whole, needed, loved and secure using life history.