Dementia Confabulation: When to challenge and when to "go along?"

So, if people contact you? You laugh gently and say "oh, you DO know that mom has been diagnosed with dementia, don't you? It's really sad that her brain is so broken at this point that she thinks that her loving children are doing bad things."

You don't argue with them; if THEY argue with you, you say "I'm really sorry that you don't understand the nature and extent of mom's disease."

Countrymouse, this first year has been rough. My sister works full-time and I'm retired, so I've pretty much been "it" for doctor's appointments; however, the good news is that we've pretty much got Mom caught up with doctor's appointments. She is fully managed now by a visiting internist who comes to memory care. The internist refers her as needed, so from now on doctor visits will be few and far between. Sister picks her up sometimes and takes her on outings. I quit taking Mom on "pleasure" jaunts months ago. I wouldn't think of taking her home with me even for a day; I care too much for my own health and sanity to involve myself in situations she utilizes as opportunities for personal attacks.

My expectation is to see Mom once a month, if that, in 2018. My policy when she gets nasty: "I'll be back sometime when you're feeling better," "I need to take you back to memory care because I'm going to visit/do so-and-so," or "The doorbell's ringing, I have to go now."

Rainmom, you're right: reasoning with dementia is hopeless. The only thing I want to do is respond in a way that doesn't support a falsehood about me or those I care about. Call me stubborn, but standing by like a numb-nut while Mom reams my sister ain't an option. For me, silence is tacit approval, even with a demented person. I guess the best thing for me to say is "That's not a nice thing to say, Mom." Please understand, I know I'm the one with the problem here. Mom has always lied, slandered, fabricated, whatever you want to call it, long before dementia set in. I know I can't fix her, dementia or no dementia. I just need to find a satisfactory way to respond to the false assertions for my sake, not hers.

Barb, I probably shouldn't care so much what other people think, but I like your responses! I will have to practice a bit (grin) until I become expert with it!

Thanks to all!

You say “you can’t fix stupid”. I have one for you that - if you can “embrace” it, will make your life a lot less frustrating: You can’t reason with dementia”. Seriously- you can’t. You’ll never win this battle and the sooner you accept it, the easier your life will become.

Amber, no you do not have to go along with insults to your face, of course not. But that's different from the kind of confabulation that you clearly understand, with your mother trying to make sense of her memories.

Offensive remarks fall under the heading of challenging behaviours rather than faulty memory. If responding proportionately with something like "that is not a nice thing to say" doesn't help or makes things worse, then there's nothing for it - you'll just have to do the "I'll come back another time" routine and cut the visit short.

Do you ever actually need to spend time with her, or is it always optional?

AmberA,
My mother and yours sound very similar. Except I am an only child and my mother attacks my very helpful and wonderful wife as well. I realize it is her real, spoiled personality coming out without the social skills to cover it up.
She started being really abusive about two years ago, making up horrible things about me and what a horrible person I am. These stories went from when I was 25 back to 9 years old. Of course the abuse was forgotten once she needed something. Which was most days.
When she fell and had to be in the hospital and rehab for two weeks, I visited daily. My wife helped with her bills, and for convenience we paid many of her expenses ourselves, just as we had with my in-laws and father. She accused my wife of stealing from her when she couldn't remember the reason for some checks.
She was just as needy and demanding when we were taking care of my two in-laws (both became nicer as they aged), a daughter struggling with serious mental issues, and a son with physical problems. A demanding, total narcissist.
One thing that helped me. I gathered up a bunch of receipts and wrote that we paid them for her on each. I included a long letter about how we helped her in spite of her abuse, and gave numerous examples of her outlandish behavior. I also wrote that she was affecting my health (true), and in the future I will just leave if I feel uncomfortable with her behavior. I also said I do not expect her to change, but that I can control how I react to her. I did not talk to her or see her for a week.
The letter seemed to help a lot. I think it was because she could read it over and not fill in the blanks like she does with a remembered conversation.
I have stuck to the walking away strategy, and refuse to engage her when she starts with the negativity about anything or anyone. I do not accept apologies from her for any reason, I tell her she will just do it again and everyone will feel worse the next time.
Her behavior is much better now, we even had her over for a meal, something we have not done in more than a year.
I still will never trust her again, and I still try to minimize the contact, but the relationship is tolerable for now. I still get the occasional call from the senior community staff when she throws a tantrum, but at least I am not the object of her hatred and have been able to minimize my own stress.
It is stressful to worry about other's opinions. The only opinion that matters is yours.

It sounds like your mom has a long history of mental illness, now complicated by dementia. Limit your contact, rehearse your pat responses and find love and support from your partnership with your sister.

When my dad told me about not being a nice person anymore, I began to get ready to leave. But I also told him that I came to bring him a shake and visit him and the first thing is complaints and not that it’s nice to see me. Then he calmed down. I think a slight confrontation is fine as long as it doesn’t get into a screaming match as you won’t win and your blood pressure will go up and your health will be affected in some way. In that case you’ve given your power away and she wins. You are the one who has control over your words and actions. Never forget that.

lkdrymom,

Your dad and my mom must have gone to the same school!

Mom's memory is very selective. She only remembers the bad stuff. One of my visits with Mom will end poorly, like they usually do. I'll leave, and she won't hear from me for awhile. Then she'll call when she needs something, referring to the unpleasantness of our last get-together but never apologizing for what she knows was nasty behavior on her part, instead assigning blame to me. Then she'll forget and the cycle repeats, over and over and over. I know it's the dementia, but I also know Mom's hard-wired narcissistic ways are worsened by the dementia. So I say the serenity prayer a lot!

I agree with enderby's advice. Your mother is still a living being who has to respond to your limits. To "embrace" her bad behavior or turn the other cheek would just reinforce her.

My mother has narcissistic personality disorder, now overlain by dementia. She has always demonized me and cut me out of the family while glorifying my drug addicted, alcoholic brother and sister. I've been all alone, without a single ally, and envy that you have your sister.

Believe me, I know this all too well...the best way I have found to handle this type of behavior from Mom is ; when she says she's going to cook the whole Thanksgiving meal when in reality I am the one doing it, that's one of the ' oh ok Mom, then I can have a day off and relax and make a joke out of it...but, for the time when she'd say ' you pulled that paper out of my hand and now my hand hurts' THAT's the time when the response would be ' No Mom, I actually grabbed you as you were falling , I would never hurt you !!!'.....there IS a difference in how you respond to their confobulations...but the MOST important thing to remember is NOT TO GET MAD AND YELL !!! Keep a low , same level voice tone and state your response. If they continue to say mean,untrue, hurtful things, I found the best way to say "I'm sorry you don't understand, I'm sorry you don't want me to do it that way, etc... and then say you have to leave. Just don't yell or say mean things back...they already are confused and upset. Another day means another day when they could be having more clarity, OR they have completely forgot about whatever it was that made them act/respond that way. Be matter of fact about whatever you need to do and then just do it. You can also offer ONE option and just say "that is the only other way we can do it - you're choice'....just make sure the other option is one of your choosing that you know is also another good way to do it.....In doing it that way, you are giving them the choice and then they think they are still in 'control'....that way, you still get it done in a better way for all and, they think they got their way. ....It works. It really does. But for the times when they are mean, then it's best to say I'm sorry you're upset, I love you and I have to go for now'....Then you don't get all upset either and keeps your blood pressure down !!! I just went thru this and it really works...