Have you ever been accused of lying or stealing, even though you were just looking to help? Unfortunately, this hurtful scenario can be fairly common in dementia care. As a person’s brain is changing, it can start to link facts and details in weird and unusual ways. This false-memory phenomenon can happen fairly early on, even when a person is only experiencing mild cognitive impairment (MCI) and not yet a true dementia.
When The Brain is Affected By Dementia
By Valerie Feurich, PAC Team Member
In a healthy brain, if an item gets lost, we tend to back-track our last steps in hopes of remembering where we placed it. However, when a brain is affected by dementia, forming new memories is troublesome, therefore making the act of retracing one’s steps extremely difficult. Instead, the brain of a person living with dementia may start to fill the memory gaps with older memories, resulting in stories that don’t quite match reality.
As an example, a person living with dementia may not have any memory of putting the tv remote control into a drawer. Instead, their brain may fill the memory-gap with one from a few days ago, when they placed that same remote onto the side table.
Always remember that to the person living with dementia, this memory is true. While their brain is effectively making up a story, the person themselves is unaware of this. To them, this manufactured memory is as real as any other, making it easy to understand how seemingly disappearing items can lead to distrust.
So if you’re a caregiver, what can you do if your person living with dementia accuses you of stealing?
1. Make sure it really is dementia
While false memories are common in dementia, it doesn’t always mean that that’s the certain cause of it. Cognitive changes can be an early indicator for a lot of things.
It could be that your person’s medications are causing them to be a little fuzzy, or that sleep disturbances are affecting their memory. Or maybe, their diabetes is less balanced than it should be. There are many possibilities, so it’s critical to get a physician’s workup if this happens frequently.
2. Try not to argue or get defensive
Let’s say you remember the details of a recent event with certainty, and someone else told you that that’s not how it happened. How would that make you feel?
Chances are, you’d develop a certain level of mistrust in the person that’s trying to convince you otherwise. So, by trying to convince the person living with dementia that their memory is false, you run the risk of reinforcing that you can’t be trusted and that you’re up to no good.
Let go of the idea of helping them get it or showing evidence to prove them wrong; that will likely backfire. Instead, try to meet them where they are through empathy.
3. Take a deep breath and try to empathize with them
So what do you do when someone says you’ve stolen from them? Here’s a sample conversation of a way in which you can respond that is less likely to end in an altercation:
- Teepa: Wow! Oh wow. So you’re thinking that I took the keys?
- Greg: Well, I can’t find those darn things
- Teepa: They’re missing! So they obviously aren’t where they usually are and you always keep them on the little table by the door. You’re absolutely right that they’re missing.
- Greg: Well, you keep stealing stuff. Every time you go home something’s missing.
- Teepa: So it feels like every time I come over something goes missing. That’s not good.
- Greg: I’m looking for something every time you go.
- Teepa: No wonder you think I’ve done something, because every time I come over, something goes missing and it’s not where it should be.
- Greg: That’s right. I’ll have to search you when you leave from now on.
- Teepa: I mean, if things go missing maybe we should check my pockets before I go. Because that must be frightening and scary.
What do you notice? Can you identify a few of Teepa Snow’s conversational techniques? Let’s see if you can find them all:
- Allowing yourself to take a breath: Notice Teepa responds with a simple Wow! Oh wow. Why? Because it allows you to take a breath and process the situation for a moment. This gives you a greater chance of responding thoughtfully instead of blurting out a knee-jerk style defensive reaction.
- Reflect: Notice how Teepa often repeats or rephrases the last few words that Greg has said? That’s because by reflecting the other person’s words, you signal to them that you hear what they are saying. Not only does that support a person living with dementia cognitively in a conversation, but it is also comforting to know that the other party is truly listening.
- Empathize with their distress: Can you pick out the conversation pieces in which Teepa empathizes with Greg’s distress? Why do you think that’s helpful? Well, as we already established, you won’t be able to fix the person living with dementia or make them believe that their memories are false. So instead, by trying to meet them where they are and acknowledging their distress, you’re diffusing the you vs. me scenario and helping to bring you both back on the same page.
4. Get Support to Protect Your Relationship
You don’t want to be a lone ranger when caring for a person living with dementia. Do you have someone, maybe another family member, that can assist? It may help to bring them in to give you a little break, or to help calm things between you and the person living with dementia if tensions are high.
You won’t want to permanently damage your relationship with them, so being able to take a step back and letting someone else take over for a little while can really help you take a breath and much-needed break. (Don’t have someone to help, and would love to get some support?
Caring for a person living with dementia can be challenging, and being accused of theft, lying, or even worse can leave you feeling hurt. While there are no one-size-fits-all solutions in dementia care, letting go of being right and taking things too personally will always help you both. Take a deep breath, a break if possible, and remember that this moment too shall pass.