How do we help Dad understand his dementia?

Higgo asked...

Hi My father-in-law has been diagnosed with early dementia in may 2010, since, he has had several outbursts of anger - and has accused the district nurses of drugging him of which they are not they just administer them to him. He has had 3 falls in the home in a span of 1 month - how does someone try to get through to a person with dementia about the safety and ways around how to do things without putting himself at risk of falling ? He won't listen to reason and just keeps saying I have always done it that way ! Does us as the carers ( Family) explain to him his dementia or do you just go along with what he says. We cannot trust him anymore of telling the truth - do we go along with it or in some instances tell him what he has got - don't get us wrong he has been told by a specialist of his problem but I think it went straight over his head either in denial or just dose'nt understand it. How does one get through to a person with this problem ? It is very hard to reason with him and frustrating on our end !

Expert Answer

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

You are very correct when you say that your father-in-law will not "listen to reason". However, early dementia compromises the individual's perception of reality, insight and ability to reason. Thus, his behavior is not intentional but more so a neurological result of his brain changes. His diagnosis is so recent (May 2010) that once you and your family are able to better understand dementia, you will become more skilled in communicating with him. Telling him what he has will not cause him to behave differently. Instead, reassuring and redirecting will divert him from danger. Explaining and advising can be very frustrating for caregivers. An easier way would be modifying your father-in-law's environment to foster safety. You did mention that he has anger outbursts and expresses some paranoia about the nurses and his medications. It is likely he will benefit from pharmacological treatment. I suggest you consult with the diagnosing physician for a drug that might lower his anxiety without affecting his balance. This can be tricky as many drugs may cause dizziness. I also recommend you follow up on the falling issue. Falling is not necessarily a symptom of early dementia and he may have another diagnosis (i.e. hydrocephalus) that might be treatable.