Paranoia is one of the many possible challenges of dementia. It’s a blaming belief or suspiciousness that a person with dementia holds onto, despite explanations or lack of proof of this belief.
Sometimes people with dementia will accuse others in the household of stealing something that they themselves have misplaced. It is very tempting to try to convince the person otherwise when they are convinced that something has been stolen. But arguing doesn’t get us very far when a person has dementia. It usually causes stress, frustration and upset for all concerned! It is more productive to “cross to their side of the street” in order to see things compassionately, from the person’s point of view. Sandra Mcgurran, social worker with Fairview Home Care and Hospice Senior Services, recently shared with me the idea that “Compassion = Empathy + Action”. This concept can be applied here.
Here are some DO’S and DON’TS to guide you in giving a compassionate response in these sorts of situations.
DO NOT TAKE OFFENSE on behalf of the accused person.
DO LISTEN to what is bothering the person with dementia, and VALIDATE their feeling, i.e., “That’s not a very nice feeling, to think someone would just take something from you.”
DO RESIST THE URGE to get into an argument with the person.
DO ACKNOWLEDGE the upset. “I can see why you’re upset. I would be too, if that happened to me.”
DO NOT offer a lengthy opinion or a list of reasons why they shouldn’t be upset.
DO OFFER A SIMPLE IDEA. “I wonder if your blouse is in the wash.” Or… “Maybe your wallet was left in a pocket?”
DO BE HELPFUL and action-oriented. “I will go check the laundry room.” “Let’s check your pockets”.
DO ASK QUESTIONS. “Let me get this right. What color was that shirt?
DO BE REASSURING. “Don’t you worry. We will get to the bottom of it.” ‘I’m sure we’ll find it”. “I’m good at finding things.”
DO SHIFT THE FOCUS. “Let’s have a cup of coffee; coffee always helps me think more clearly!” Be sure to offer something you know the person will be interested in!
DO DUPLICATE items that are repeatedly misplaced. For example, if a person often loses their wallet, obtain several of the same kind to keep on hand. Make copies of cards that are in the original, so you can stuff the replacement wallets with those.
But what if YOU are the person being accused directly? This can certainly be tricky.
It’s hard not to feel hurt by such an accusation. What can you do?
DO LET THAT ROLL OFF YOUR BACK in favor of remembering that your family member is functioning with a brain that is doing the absolute best it can possibly do under the circumstances of dementia.
DO TRY IGNORING THE ACCUSATION. Instead, simply validate the person’s feelings, i.e., “Oh no! Your favorite blouse is missing? Of course you’re upset. That’s a beautiful blouse!”
Maybe this will distract the focus from YOUR culpability, or maybe not. Depending on the level of the person’s upset and suspiciousness, you might need to step away and if someone else is available to assist. In that case, try, “I can see you’re upset with me. I’ll go see if Ann will help you look.”
DO THINK AHEAD. For things that are frequently misplaced, it could be helpful to establish and clearly label a home base in the room where a purse can hang or a wallet can sit. You might initiate a routine of checking that spot every night together.
Finally, it can really help in any sort of frustrating situation with a person with dementia to MAINTAIN A SENSE OF HUMOR AND GOOD WILL towards the person. Is there a way you can turn that uncomfortable situation around and actually give the person a compliment? Maybe you can remind them of advice they once gave you! “You know, Mom, I remember you telling me when I lost stuff that I would forget my head if it wasn’t attached. You were so right! You also said that lost things usually turn up if we are teensy bit patient! That was always so helpful!”
For more info on coping with paranoia as well as other challenges that can arise with dementia, see Coping with Behavior Change in Dementia: A Family Caregiver’s Guide, by Beth Spencer and Laurie White.
--Marysue Moses, Ebenezer Dimensions Program Coordinator
Many older adults think about moving to a senior living community, or have had talks with their family members about moving, but often have the feeling that they are ‘not ready.’ At Ebenezer, we hear you. (We also hear “I don’t know why I waited!” but that’s another article.)
Just because you’re not ready now, doesn’t mean you can’t work on getting things in order when or if you move. And even when you’ve taken care of the things below, it still doesn’t mean you have to make a move. It’s always best to be prepared. So if you want to or have to make a move, you’ll have the important pieces all ready to go!
Visit Your Doctor
Hopefully, you are getting your regular check-ups with your primary physician, but if not, make an appointment. Have the doctor review your medication list to make sure the list is up to date and appropriate. Let him or her know that you are considering a move to senior living. If you end up needing to move to an assisted living setting, your doctor will have to sign off on orders. This can happen more quickly (and more smoothly) if you have recently seen your doctor and have had these discussions in person.
You have 2 assignments here.
Depending on where you want to be, what type of apartment you want, and what service level you need (senior living, assisted living, memory care or enhanced care) you may encounter long waiting lists. When you do your research and shop around, ask about waiting lists and get on a few of them. There’s no guarantee something will be available for you when you are ready, but this gives you a little more priority and increases your odds of getting the apartment you want when you want or need it.
When you move to a senior living community and it comes time to sign a lease, you will likely need to identify a Power of Attorney and Health Care representative, and you may need to provide copies of the forms. Make sure you have quick access to your notarized Power of Attorney form and your Health Care Directive.
That’s it! You may have noticed there is no ‘to-do’ item for the house. Even though getting the house ready, or needing to downsize, is a reason many people feel they’re not ready for a move, a lot of times, when people make a transition, it’s not because they’ve finished downsizing and their house is in perfect condition to sell. When you decide you’re ready, you’ll figure out quickly what to do with your house and your stuff. There are realtors and move managers who specialize in working with seniors who can make your move and the sale of your home a breeze!
We know it’s not easy, and that’s why we’re here to help. Consider us a resource full of options to help you navigate different options available to you, even if it’s not with our community.