The #1 Dementia Don’t!

Don’t ARGUE!

It always amazes me at the number of individuals that I come across who act as though arguing with someone with dementia is going to get them anywhere.  The mere fact that the person has dementia should indicate to you that s/he does not have the cognitive ability to form good judgments, to track time well, to reason out an argument, or to merge multiple variables accurately.  So what makes anyone think that arguing or attempting to orient a demented individual to reality will really work?!

Take the following true exchange that happened between mother and daughter:

Mom with dementia:  “You never call me!”

Daughter:  “Mom, I call you all the time.  In fact, I called you last night.”

Mom:  “You did not!  I never thought that I raised a liar!”

Daughter:  “I’m not lying to you, mom.  I called you last night and I even told you that I would be here to visit you today, and here I am.”

Mom:  “You’re only visiting me because you’re feeling guilty that you never call.”

The conversation went on and on this way and the mother just became more adamant and agitated.  I finally interrupted the daughter and very kindly, but firmly asked her to just listen and watch as I took over the conversation with her mother.  The conversation went as follows:

Me:  “Betty, I can tell that you really love your daughter.”

Betty:  “What’s that got to do with anything?!”

Me:  “Well, because you love her so much, it really hurts you when she doesn’t call or visit.”

At this point, the daughter tried to interrupt again with her argument that she, in fact, DID call.  I asked that the daughter not interrupt and I turned back to the conversation.

Betty:  “How did you know that?”

Me:  “It was just a hunch.  Besides, I think your daughter loves you too.”

Betty:  “If she loved me, she’d call me.” (with a darting glare at the daughter).

Me:  “What’s the worst thing about not hearing from your daughter?”

Betty:  “I’m alone.”

Me:  “So, you feel abandoned when she doesn’t call or visit.”

Betty:  Turns to her daughter, “see, SHE gets it.”

Outside of the room, I explained to the daughter that I knew that she had called her mother – that wasn’t the point of me seemingly “siding” with her mom.  I further explained that most individuals with dementia have lost the ability to reason and that attempting to reason with them just frustrates everyone. This is because our tendency as non-demented individuals is to correct and to try to bring the demented individual into our reality.  But whose reality is it?  And is it really important that we are right and they are wrong?  I didn’t believe that the daughter didn’t call – her mother did.

Furthermore, challenging a demented person’s reality only serves to put him/her on the defensive, and his/her response will put you on the defensive which only leads to anger and agitation – not a good combo – and a vicious cycle ensues.

So, what did I do that was different?  It’s called validation.  Validation focuses on emotions.

The ability to remember true events and to reason are higher cognitive functions; however, the ability to receive internal and external stimuli and to feel emotions are lower cognitive functions.  Therefore, feeling and emotions are what individuals with dementia can relate to and these are what will connect you, NOT arguing over who is right or wrong in the situation.

The moment that her mother stated that the daughter never called her, the daughter should have recognized that this was no longer a conversation about reality.  It was a conversation about her mother’s reality and what her mother was feeling – not what her mother was thinking.

So, the next time you sense an argument coming on, stop yourself and try to look for the emotion involved.  Name the emotion.  Talk about the demented person’s needs and acknowledge their feelings.  You’ll be amazed at the conversations that will take place!

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