How should I tell my mom that she has dementia?

A fellow caregiver asked...

We have mom in assistant living and she keeps telling us that she is moving and renting a house. How do you tell her that she has dementia?

Expert Answer

Ron Kauffman is a certified senior advisor (CSA), senior lifestyle radio host, syndicated newspaper columnist, and the author of Caring for a Loved One With Alzheimer's Disease. In addition, Kauffman is also the primary caregiver for his mother, who has Alzheimer's.

Dear family:

I too have a mother in assisted living. She also has dementia, in the form of Alzheimer's disease. I sympathize with you, as we've gone through this same challenge of her "moving" as you're facing with your mom.

The fact that your mother raises the issue about moving and renting a new home is not surprising. Many dementia patients have very real delusions of doing things like moving, and truly believe that their words and actions are normal. Because for them, due to their dementia, those behaviors are "normal."

Some of our clients have been known to get up in the middle of the day and night, get fully dressed, and try to walk out the door. When stopped by a family member, caregiver or facility staff member and asked where they're going, they clearly say things like, "To catch the bus to work"¦" or "I have a meeting today"¦" and in your mother's case, which we have heard many times before with our clients, she believes she is moving and renting a new place to live.

Trying to explain dementia to your mom in the hope that she'll understand that she has a cognitive illness, usually results in one of several less than satisfactory outcomes: a) she simply doesn't understand or denies your explanation; b) she says she understands, but forgets the conversation within hours; or c) your telling her she has an illness has the effect of making her feel that you're being confrontational.

When a patient makes a statement such as the one your mother has focused on, it can be very helpful to use another approach. I'd suggest that you say to her something along the lines of, "Mom, you've already moved. This is your new house. Look, there are your pictures of the grandchildren, and your clothes are already hanging in the closet."

The concept here is to not only redirect her thought process, but to help get and keep her grounded in the reality that the assisted living is the new place to which she has moved and is now a resident. It's not necessary to have accurate dates as to when she moved, or tell her she's been there for whatever period of time that has passed.

Your goal is to provide praise and support for the beautiful place she chose to rent, and how nicely she has decorated everything. Be patient, keep up the positive reinforcement, and if necessary redirect her thinking by asking her to show you where she put a particular photo or keepsake that you know she has with her in the apartment.

The occasional "white lie" is acceptable in this situation, but trying to explain things to her that are rational to you by saying, "Don't you remember"¦" isn't going to resolve this situation.

I'm certain that you can achieve some positive change by trying this approach. Good luck.