I recently started volunteering at an assisted living community. They matched me up with someone they felt needed some extra time for interaction and told me he/she had beginning stages of dementia. I have been trying to hold conversations with this person but they seem to be having a hard time following conversation and will tell me the same story 3 or 4 times all with different details. I understand this is part of the disease but I'm worried, I may end up upsetting this person. How do I talk with someone with dementia? The staff told me to talk about past events she would know well but the individual cannot seem to express anything without changing huge parts of the story.
The staff provided me with some tips but seem to be really preoccupied with their daily tasks. I want to keep volunteering but I dont want to harm anyone.
Where can I get some good information how to talk with people with dementia? I dont have much background on the person and cannot tell what really happened over what did not. Or is that even important at this point?
You're wonderful for volunteering at the community, clearasday. I hope that it is enriching your own life. The only advice I would give about talking to someone with dementia is not to argue with them or try to correct. Complex questions that require reasoning might confuse them. Many people like to talk about their pasts, so all you can really do is listen and tell them about your own experiences. It really isn't too hard to talk to someone with dementia, though it can be confusing to listen to them when things don't fit. When they seem not to fit, just think to yourself that it isn't important.
Older memories are usually very well preserved.
(If the story is that the staff is abusing this person, then the truth matters. Otherwise, not so much.)
It is kind of you to be so concerned about saying and doing the right things. People with dementia are usually so fragile that a comment is going to set them off or damage them. Relax a bit. :)
My mom has 4 daughters and she gets 7 or 8 visits every week plus once in a while some from her sons. I am always so sorry for the residents who get almost no visitors. I know that the staff tries to give them extra attention, but it is wonderful when there are volunteers to provide some interaction! Thank you!
A book you might enjoy is "Creating Moments of Joy" by Jolene Brackey. And here are some articles on this site that may be helpful:
https://www.agingcare.com/articles/tips-for-talking-to-someone-with-alzheimers-153899.htm
https://www.agingcare.com/articles/communicating-with-dementia-patients-150914.htm
https://www.agingcare.com/articles/respond-when-dementia-causes-elder-to-repeat-150912.htm
What you are doing is valuable!
Learning about and accepting Confabulating and Confabulations has been
essential and not easy to accept.
In psychology, confabulation (verb: confabulate) is a memory
disturbance, defined as the production of fabricated, distorted or
misinterpreted memories about oneself or the world, without the
conscious intention to deceive.
Key factors in confabulations are there is no intent to deceive,
second the person being unaware that the information is blatantly
false. Confabulating is distinct from lying because there is no intent
to deceive, and the person being unaware that the information is
blatantly false. Carers challenge: is what they say true?
Confabulations become a far greater concern in the later stages,
because confabulations are much more likely to be acted upon.
It is difficult for everyone to accept a mind is damaged by
Alzheimer's Disease. Not only is memory damaged their ability to
process thoughts and conversations is impaired.
Confabulations are a major annoyance and can be dangerous- when we the
take everything in a discussion at face value. Confabulating is very
frequently observed in people with Alzheimer's.
We all Confabulate when we make..verbal statements and/or actions that
inaccurately describe history, background and present situations
unintentionally. We must be aware of information that is blatantly
false yet are coherent, internally consistent, and appear relatively
normal.
Understand the similarities between confabulation and delusions; e.g.,
both involve the production of unintentional false statements, both
are resistant to contradictory evidence.
Recognize Sunrise Syndrome delusions that are frequently observed in
Alzheimer's patients include beliefs about theft, the patient's house
not being his home, a spouse, is an impostor, belief an intruder is in
the house,abandonment, spousal infidelity, and paranoia.
http://www.alzcompend.info/?p=293
It seems that Alzheimer's world is fraught with confabulation speak.
The general public doesn't understand Alzheimer's they certainly need
to be educated regarding Confabulation.
{Quoting http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
"Most patients with spontaneous confabulation eventually stop
confabulating."
"Confabulators may occasionally act upon their confabulation."
("Occasionally"? Later-stage Alzheimer's patients persistently and
repeatedly act upon the belief their childhood memories are relevant
to their present circumstances.)
"Confabulations are usually limited in time; they relate to the recent
past, the present, and the future."
{End Quoting http://tinyurl.com/qfutbn4 Nature Reviews Neuroscience }
An aide/caregiver must understand the individual has Alzheimer's
Disease, be aware of the danger, and treat the person with patience.
Also, Confabulation is common. Conversing with someone who has
Alzheimer's is often like talking with your cat.
Acknowledge, respond, be affectionate, develop boundless patience.
Forget about rational responses. Show respect, your therapeutic
fictional responses are allowed. ~{quoting}DLMifm}
To cope with spontaneous confabulation, and ease the confusion,
frustration, and fear for the loved one, use resources such as:
Jennifer Ghent-Fuller's paper "Understanding the Dementia Experience"
Jolene Brackey's book, Creating Moments of Joy
By far, the most serious danger posed by Alzheimer's disease is when
the individual may decide they want to go for a walk, go searching for
"home," or maybe just walk outside to get the paper. In a restaurant
they may go to a rest-room. When they turn around, the place they
expect to see is gone. Their assurance they are Ok and can go on their
own ?. may be a example of confabulation.
----
Alzheimer Society of Canada, http://tinyurl.com/oujghvy Toronto,
Ontario, M4R 1K8
Hallucinations and delusions are symptoms of Alzheimer's disease and
other dementias. With hallucinations or delusions, people do not
experience things as they really are.
Delusions are false beliefs. Even if you give evidence about something
to the person with dementia, she will not change her belief. For
example, a person with dementia may have a delusion in which she
believes someone else is living in her house when she actually lives
alone. Delusions can also be experienced in the form of paranoid
beliefs, or accusing others for things that have not happened. For
example, the person with dementia may misplace an item and blame
others for stealing it. Some people with dementia may have the
delusion that others are "out to get them." For example, he
may believe that his food is being poisoned.
Hallucinations are incorrect perceptions of objects or events
involving the senses. They seem real to the person experiencing them
but cannot be verified by anyone else. Hallucinations are a false
perception that can result in either positive or negative experiences.
Hallucinations experienced by people with dementia can involve any of
the senses, but are most often either visual (seeing something that
isn't really there) or auditory (hearing noises or voices that do not
actually exist). For example, a visual hallucination could be seeing
bugs crawling over the bed that aren't actually there. Of course,
people also make “visual mistakes,� mistaking a housecoat hanging
up for a person, for example, because they can’t see the object
clearly. This can happen to anyone, and is not considered a
hallucination.
-----
Definition of Alzheimer's Sunrise Syndrome
Internet description: cognitive instability on arising from sleep.
Sunrise Syndrome,(sun?riz) a condition in which a person with
Alzheimer's wakes up rising in the morning and their mind is filled
with delusions which include include beliefs about theft, the
patient's house not being their home, a spouse is an impostor, belief
an intruder is in the house, abandonment, spousal and paranoia, people
eavesdropping. Sometimes the person may carry over content of a dream.
One observation is that Sunrise Syndrome is different from Sundowning
because the person may wake up in a confabulation mind set. During a
Sunrise Syndrome conversation with the content may filled with
confabulations; verbal statements and/or actions that inaccurately
describe history, background and present situations.
Sundowning in contrast displays as confusion, disorientation,
wandering, searching, escape behaviors, tapping or banging,
vocalization, combativeness; the demons of anxiety, anger, fear,
hallucinations and paranoia come out.
===
When I became a caregiver for my wife with Alzheimer's I had no
clue to the tasks ahead. I started to read and search the Internet for
information.
Now retired I enjoy blogging and networking. I am an Aggregator to
Ishmael's Knowledge Network, I frequently collect content from various
Internet sources and consolidate it on Ish's Knowledge Network
http://tinyurl.com/4qqekc6
Knowledge networking is a pastime / hobby. BTW I have no
commercial ties to the linked information.
Angel's work, I tell you. ;)
You are going to be just fine!