Dementia and Confusion: Should You Step Into a Senior’s Alternate Reality?

Dementia and Confusion. Caring grandson and his grandfather
Dementia and confusion usually go hand in hand; here’s how to help.

Dementia and confusion usually go hand in hand, and can lead to recent memories being forgotten or altered, while those from the more remote past often stay unimpaired. This can cause past events to make more sense to an older adult with dementia than the present. A person’s alternative reality can be the senior’s way of making sense of the present through past experiences.

Seniors with Alzheimer’s disease frequently are challenged with expressing themselves, and in some cases their alternate reality has more to do with a requirement or a particular feeling they are attempting to express than it has to do with the words they are saying.

For example:

  • “When is my wife going to be coming home?” This question might be more about the need for affection or acceptance or a home cooked dinner than it could be about wishing to see his wife, who passed away many years ago. An appropriate reaction to find out more might be, “Why are you wanting to see her?”
  • “I need to take all these casseroles to the neighbors before the end of the day.” Even though these casseroles do not exist, the words could actually indicate a need for meaning and purpose in life or wanting to be engaged in an activity. A good reply to find out more could be, “Why did you decide to make casseroles for your neighbors?”

Keeping a log of these kinds of events can help you observe a pattern in the person’s dementia confusion. The more you listen in and pay close attention, the easier it will become to perceive the thinking behind the alternate reality and the most effective way to respond.

Is It Alright to Play Along?

Providing the scenario is not going to be unsafe or inappropriate, it is perfectly fine to play along with your loved one’s alternate reality. Doing this is not going to make the dementia worse. Bear in mind, the person’s reality is true to him/her, and playing along can make the senior feel more comfortable.

If the situation is inappropriate or may cause harm to the senior, try to react to the perceived need while redirecting him/her to something safer or more appropriate.

Keep in mind the following 3 actions:

  1. Reassure the older person.
  2. React to his/her need.
  3. Redirect if necessary.

Also, call on the Nashville, TN elder care team at Stay Home Care (also serving surrounding areas), for specialized dementia care. Our dementia caregivers are here to offer compassionate, professional respite care services for family caregivers who could use some time away to refresh and recharge. Reach out to us any time to learn more at 615-964-7726.