I don't know how to handle conversations with my mom when she has dillusions. Help!

1 answer | Last updated: Sep 14, 2017
Trexel asked...

My mom is in the mid-stages of Alzheimer's and recently has shared with me, and others, that she hasn't seen my dad for weeks and doesn't know where he is. My dad is my mom's primary caregiver and doesn't EVER leave her. How do I handle Mom's comment/concern about not seeing my dad. Oh yeah, for almost a year she has said that four gentlemen take care of her, one happens to be my dad, but now my dad is out of the picture. I think sometimes she realizes my dad is there and other times he's not. I don't know how to handle these kinds of conversations with my mom.

Expert Answers

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

The most concise definition of a delusion is 'a false belief'. The operative word, when communicating with Alzheimer delusions, is BELIEF! No matter how seemingly ridiculous the delusion for the person with Alzheimer's disease may seem to you, to her it is something she truly believes to be true. Most always, correcting or reasoning or explaining to someone who has is slowly losing the ability to reason results in a negative confrontation - the cognitively intact person vs the delusional one. If previous attempts to reason with her have failed, I strongly urge you to be in her world while she is making delusional statements. Try to feel her dismay. Instead of explaining Dad's presence or absence, try reacting to her emotion rather than her words. The result may be a 'fiblet' or a therapeutic fib used to turn the scenario into a positive interaction. For example, the next time she comments that she hasn't seen your dad for a long time, try saying something similar to, "Dad had to go the market, he'll be back soon" or "Dad is helping Uncle John" or "He is playing poker with the boys" - whatever works for you. Use an explanation that would be logical during the time before Alzheimer's took away her reasoning capacity. Ask yourself 'What is Mom really saying'. Although at first it may feel counter-intuitive, listen to the emotion behind the failing words and respond only to that emotion. It sounds to me that, at the moment of stating the delusion, she is missing him and feeling a bit lost without his presence. By affirming that he will return soon you have turned what could be a catastrophic reaction into a simple explanation (regardless of the validity) of why he may not be there. As for the four gentlemen who care for her in this particular delusion, try another fiblet by having an upbeat positive conversation about how wonderful these men are and how fortunate she is to have them care. Reassure her that you (or someone else) will be with her - she will not be alone. Chances are the delusions will continue but the outcome will be considerably more pleasant. Remember the 3 Rs - Reply, reaffirm, and reassure.