How do you handle confusion and frustration over not remembering information?

4 answers | Last updated: Oct 14, 2016
Dnbayer asked...

My dad always tells my mom information that she does not recall. Upon telling her again, her response is "You didn't tell me that. Why didn't you tell me that?" Dad will then tell her he did tell her, but that only results in Mom becoming upset, resulting in an extended of period of negativity and irritability. What is the best response for my dad to give my mom that won't make my dad the "one who is losing his mind" according to Mom, yet not raise her ire either?

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.

You certainly describe the situation perfectly and rest assured the same scenario is occurring in hundreds of AD-homes across the country. You are completely justified in expressing concern about Dad's repeated need to share information with your Mom that only results in frustration and confusion when he expects her to recall the info.

The information was never stored in the brain so it is impossible to later remember it. It is rather like a file cabinet that is crammed full and not one more piece of data can fit in - so it is with the short term memory center in Mom's brain.

You might try suggesting to your father that he limit the amount of information he gives her and to NEVER expect her to remember. This may seem counter-intuitive to him since he is accustomed to sharing daily facts with her. Her brain, however, is no longer functioning as it was previously when sharing info was a daily occurrence.

Let Dad know that walking in her world may help him to comprehend the agitation she expresses when she can't recall. If she is angry that he 'never told her something', the best reaction is to apologize and say, "I'm so sorry. I have a lot on my mind. I forgot to tell you". That kind of response (a fiblet) generally diffuses potential animosity. Ask him to try it a few times and I'm sure he will see that a more peaceful environment is created.

Learning to use these 'therapeutic lies' not only begins a more positive interaction but it also assists your dad in taking care of himself while it helps your mom to feel more relaxed and less challenged. Do remember to take care of you!

Community Answers

Smindian answered...

I do agree with the above answer, but I'd like to add that rather than "lie" to the individual, it might be better to say, "If you don't remember my telling you, I am sorry. Let me tell you again and maybe we can write it down for you to put on your dresser, mirror, or some other place so that you can refer to it." That helps the person become partly responsible and helps him/her to find ways to compensate for the short-term memory problem. Of course, it depends on how advanced the dementia is. This solution is probably for those who are still acknowledging the fact they are losing it and are trying to find help for their short-term memory loss.

A fellow caregiver answered...

When my mom was informed of her Alzheimers diagnosis, and we encountered this type of situation, it worked to matter-of-factly reply:: "That's just part of Alzheimer's, and it's ok. You don't need to remember everything all the time. Nobody does, and it's not your fault." Later on, instead of "fibbing", a more diplomatic response to her anger might be " You're right. I don't always remember to tell everyone everything I should. I can see how you would get irritated with me." - which is truthful, but still deflects the anger issue by making her "right", or at least "not wrong".

A fellow caregiver answered...

Referring back or having a reference point in memory is not much help to one who has lost most of their memories. In fact, it can make them feel as if they must "learn" this and that can be a lot of pressure on someone who can no longer learn. Like my dad says to me on occasion, "Take it easy Annie".
Mostly I will not ever refer to the fact that I already told him and simply repeat it again for him, after all it only takes a few minutes to do this. Once you have upset an A/D patient it is hard to get them to calm down so why do it in the first place? My dad still remembers many things and because I live with him full time I recognize the moments he is more or less lucid and will then talk about his distant past with him, telling him stories about his life and making him smile. I tell him I am proud of him for remembering that. I encourage him all the time, and say often, "Dad, we are not meant to know everything, we are not God, we are only human and it is really fine to forget sometimes, I do it all the time daddy!" This sort of comment he will look at me and say, "I understand".
Sometimes we have to fib, like if he is heading out the door and it is not safe for him outside due to heat or in climate weather. We will tell him, "the door must be locked from the outside, but you did really well walking all this way, do you think you can turn around now too?"
Dad barely walks due to he has Parkinson's as well, but he wants to walk all the time. He is never left alone, and therefore the time thing is not so confusing to him. HOWEVER, if I am right there but he cannot see me, he will call for me as if I have left him for good.
So I try and eat/do my work/play with the dogs right there in front of him on a card table so he can refer back up to me if he needs to. I know that some of you might have a problem with "fibbing" but honestly it is necessary at times. If something terrible has happened, for example, dad might not have any idea what it was but he will sense others are upset, and he is very clear on empathy. So often we will make up some story, "Oh dad I am so mad with myself for losing my keys again!" I would not tell him something horrible, like the day when an accident occurred in front of our house. The reason for this is because something scary they can focus on or carry over into a later part of the day or night. Even when we watched the Titanic together, he went to bed thinking we were going to sink! So be careful what you say and HOW you say it. Be careful what you tell them cause it can scare them, after all you would be scared too if your brain was failing! And remain gentle and kind. If you cannot be within their sites all the time, or if it is too much for you as the caregiver then find some really good aides (someone who is encouraging and has a sense of humor) to help you keep an eye on him/her. You will be better at your job of caretaking if you dole out some of the responsibility.
My dad has been with us 5 years with A/D and has significantly declined both physically and mentally, but he still smiles and says hi to every member of his family. He gets a shower daily, and he is well looked after so that time and repetition do not upset him, he remains in the best possible health he can be for his condition. I doubt this would be true if he was in a corner somewhere in a nursing home. I hope this helps those of you who fear lying or get upset with repeating things, just try and see it from their perspective with sweet tones in your voice, upsetting them can get out of hand very fast! Always. annie