Delusion and Dementia: How to Cope

January 20, 2016

By: Ted Doyle, Director of Corporate Marketing & Public Affairs

For families caring for a loved one in mid-to-late stage dementia, one of the most unnerving aspects can involve delusional thoughts – fixed, false ideas that can crop up out of nowhere, and cannot be reasoned away. When Dad’s at your kitchen table convinced he’s sitting at his college dining hall, your first instinct might be to correct him and bring him back to reality, perhaps saving him the embarrassment of being confused. “Dad, you’re in my kitchen in Newton – you think you’re back at Yale? That was over 50 years ago!”

Unfortunately, that response – while meant to be reassuring and grounding – is only likely to confuse Dad further, sadden him, or even make him angry. People with dementia are in a constant struggle to make sense of their surroundings while undermined by declining cognitive function – so hard for loved ones to witness, and such a profoundly lonely and isolating experience for the sufferer.

Years ago, soon after I joined LCB, I witnessed a positive outcome from a similar episode that has stayed with me ever since. I was paying my first visit to one of our Memory Care Neighborhoods, and walked in to the sound of piano playing. When I rounded the corner, one of our residents was seated at the piano, dressed in a tuxedo and happily playing away. He finished, returned to his room, changed into his regular clothes and went about his day. When I asked a staff member about it, she explained that he had come for breakfast and announced that he had a performance that night at Carnegie Hall. Instead of correcting him, one of the nurses responded, “Well then, you’d better get practicing!”

Her instinct to go with the moment and not fight his delusion allowed the gentleman (and her!) to avoid the unnecessary trauma of being told he was wrong, and becoming more confused and upset. Now of course, it can be easier for a professional to have such a dispassionate reaction – it’s not her Dad or husband dressed in a tuxedo at 9 AM. But considering we all want what’s best for the person experiencing delusional thinking – whether it’s Mom or Dad, a neighbor or someone we’re caring for – it’s worth the effort to learn a healthy detachment in these situations.

As caregivers and family members of dementia sufferers, we know we can’t escape the unsettling symptoms of dementia. We can engage people in activities to stave them off, like the memory work we offer every day in our Memory Care Neighborhoods – but we can’t outrun the fact that we’re dealing with a progressive disease. What we can do is make a positive difference in the way our loved ones experience these delusional episodes – by choosing to stay in the moment and fight the instinct to try and bring the person back to a reality they can’t always share.

There’s a lot of helpful info online on the subject, including this piece we like from the Alzheimer’s Organization.