Is it always a good idea to not contradict a person with dementia?

Posted by bclane @bclane, 4 days ago

I recently saw a list of the three "golden rules of dementia care." They are:
1. Don’t ask direct questions.
2. Listen and learn from the person living with dementia.
3. Don’t contradict.
I have no objection to the second one, but I'm curious how others are handling the other two. I can see following all three when a person is in later stage dementia, but what about the early to mid-stages when there are times of clarity?

I guess I'm putting myself in their place, which may not be a good way to judge. But I would feel patronized if I said something that wasn't so and no one told me, then later I had a moment when I realized it wasn't so. Not to mention it's really hard for me not to correct something my husband says that's inaccurate and it's hard for me not to ask him if he remembers a particular thing, especially since sometimes he does. And when he doesn't, I explain it to him, and he seems okay with it. Other times something comes up and he doesn't know what I'm talking about. An example is that he can't remember who some of our neighbors are, and when their names are mentioned, he questions it. I explain who they are and where they live. He never seems offended or upset when I do.

I tend to talk to him as the adult he is and not as if he's a particularly slow child, which is what rules 1 and 3 make me think of. Now, as things progress, those rules might apply more. And I could see those rules being applicable if the person with dementia got really upset when asked if they remember something or if they're corrected. My husband doesn't get upset, so I know I'm lucky in that respect.

I'd love to hear how others are handling the early and mid-stages with this.

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

jeanadair123 | @jeanadair123 | 3 days ago

I try not to contradict, there is no point it just ruins our day. They say patience is a virtue it’s so true, I am trying really hard not to say any thing that will result in a confrontation, as I said what’s the point. My husband I have noticed remembers things that didn’t happen or did but not the way he remember them. My favorite word is okay. I have also noticed that he calls things by a wrong name, that I find difficult since I am not sure what he means? I love this man he has been my rock and I will be damned if I will allow this illness which he has no control of ruin the life that I have left with him.

maryvc | @maryvc | 2 days ago

This is a great thread. I agree that it’s a moment to moment journey. My husband reacts best to a smile, patience, a kiss, and as if his needs are the only thing in the world. Since I also have needs I’m not always the perfect caregiver. I need sleep and a break so that I can react with perspective.
I have no idea how this is all going to land. I know I’m breaking rules. Doing my best and I see that you are all doing your best too.

windyshores | @windyshores | 2 days ago

My mother had a delusion that she had a car and it was parked near a certain store. This was a repeated idea that was causing anxiety. So I told her she had given her car to my daughter. This was contradicting her but she showed huge relief.

She also had the idea that many of her clothes were in a closet in Vermont, at my brother's house. In that case I just told her that I would get them. That brought relief. It was clear that telling her that wasn't true would cause an argument and distress.

That is the kind of discretion needed and it is very hard. If we make a mistake (I did at one point first tell her the clothes were all in her current closet!) they forget (the advantage of dementia!) and we can do better next time!

This is a nice thread with people who care. Kudos to all!

judimahoney | @judimahoney | 1 day ago

In reply to @maryvc "This is a great thread. I agree that it’s a moment to moment journey. My husband..." + (show)

Are there rules? I feel like this is the old Wild West and there are no rules. We are mostly on our own.

maryvc | @maryvc | 1 day ago

That’s for sure. If I have to abide by too many rules whose definition change daily, I would be overwhelmed by guilt. Forgiveness and reset are magic words around here.

bclane | @bclane | 1 day ago

In reply to @judimahoney "Are there rules? I feel like this is the old Wild West and there are no..." + (show)

The old Wild West! That is a good description! 🙂

windyshores | @windyshores | 1 day ago

There are several lists of what not to do and what to do with a person with dementia. I wouldn't call them "rules." They are intended to guide. And every provider has told me that discretion is required and every situation is different.

carolhl12024 | @carolhl12024 | 11 hours ago

In reply to @maryvc "This is a great thread. I agree that it’s a moment to moment journey. My husband..." + (show)

That's all you can do hon. I have proceeded to have my hubby's Primary Dr call in the CPAP machine. He is sleeping 24/23..up maybe an hour..he does have sleep apnea as well but wouldn't wear the mask before. I told him nicely choices: St Elizabeth intake sleep apnea study or mask at home of course he chose later. Dementia and sleep apnea have similar characteristics so I want some answers sleep apnea or dementia? He is not eating..he's weak and this is scary so I am going to try to help him. He is lashing out at me and I could cry as I have lack of sleep because of him and I am devoting myself to his health but yet he claims I am not doing anything for him....I zip my lip!

jehjeh | @jehjeh | 10 hours ago

In reply to @carolhl12024 "That's all you can do hon. I have proceeded to have my hubby's Primary Dr call..." + (show)

I'm glad you are looking at all possibilities. So often, we get a diagnosis for a particular illness and everything is blamed on that.

Im sorry for what you're going through. The lashing out is hard to put up with. We caregivers are compromising our own physical and mental health with little to no understanding from our loved one. I too hear that he has no one to take care of him. I think it's time for a counselor for myself, just need to find a way to get away for even a brief phone conversation.

I'm praying for the wellbeing of all who are walking this path.

wctdoc1943 | @wctdoc1943 | 10 hours ago

Do what works that does not cause agitation or an argument. Our job is to protect with dignity. Every patient is different and even the individual may vary in cognitive capacity in the early and early-mid stages. We have to adapt with them. Their beliefs and their delusions are real to them. I try to find what works to keep my wife calm and as happy as possible. Sometimes that involves lying or agreeing with things that are not true or real. The intent is not to deceive but to maintain peace and harmony.