What's the Best Way to Handle My Mother's Accusations That My Father Is Having an Affair, When He's Been Faithful to Her for the Forty Years They've Been Married?

A fellow caregiver asked...

What's the best way to handle my mother's accusations that my father is having an affair, when he's been faithful to her for the forty years they've been married?

Expert Answer

Kathryn Pears, who has a master's in public policy and management, has been involved in dementia care for 30 years. She was a caregiver for her father, who had early onset Alzheimer's disease, and cared for him at home until his death in 1991. She was director of Public Policy and Education for the Alzheimer's Association, Maine chapter, until June 2011, when she left to create Dementia Care Strategies, where she provides consulting and training services to family and professional caregivers about all aspects of caring for someone with Alzheimer's disease or a related dementia. In addition, she has led multiple legislative initiatives in Maine to improve care for individuals living with dementia, including passage of a Silver Alert program to track missing people with dementia as well as special care unit disclosure.

1. Never argue. Arguing with a person with dementia is always fruitless and will only result in increasing everyone's stress.

2. Rule out any medical issues. Any sudden change in behavior should be reported to a physician to determine if a medical evaluation is necessary.

Ask your father:

a. Did it come on very suddenly? If so, it might be related to a urinary tract infection or some other physical illness.

b. Has a new medication been prescribed recently? If so, it could be a reaction to the medication.

3. Distract and divert. Although it will be difficult for your father, ask him to empathize with the emotion behind the accusation. Your mother is likely feeling very insecure and worried by these beliefs. He should validate the emotion by saying something such as, "You seem upset," in a reassuring voice. Then refocus the conversation - reminisce with her about something that brought her pleasure in the past (a vacation, special occasion or hobby), go for a walk, sing a familiar song with her, offer a special treat, etc.

4. Medication as a last resort. If neither of the above work and the accusations are causing your father extreme distress, you may need to discuss with her physician whether a trial of medication might be warranted. Medications used to treat these kinds of disturbances do carry a high risk of adverse reactions, however, so only consider this route after carefully weighing the risks and benefits. A consultation with a geriatric psychiatrist might be worthwhile.

5. Try a support group. If he hasn't already joined a support group you might encourage him to give it a try. He is not alone and it is likely that he would meet other caregivers who have had similar experiences. Most local newspapers carry a listing of support groups in their area.

Reassure your father that although hurtful, your mother cannot control these thoughts. The damage that is occurring in her brain as a result of the disease process is causing her to misinterpret her environment. Remind your father that it is the disease talking and not anything he has done to precipitate her accusations.