How would you handle this Dementia-induced obsession?
My client is a bit more strong physically than he was a few weeks ago, but his Vascular Dementia is progressing. He has been obsessed with something from day one (back in late summer) and some days it gets to be very detailed and scares him. The gist of the story is that, while he was in the hospital (sometimes he says this was a few weeks ago, sometimes a year, sometimes days), the "city" moved his house, and his neighbor's house, to their current location.
Sometimes the story gets very lengthy and complicated, and the house isn't his at all, but was moved there by the city and now they have to live there, but it was free. He doesn't know why it was free, and what scares him sometimes is that it could be taken away again as easily as it was given.
How I've handled it so far is to take him for a walk around the house and inspect the foundation. It looks great. I also take him for walks through the neighborhood to talk to neighbors on both of the days I'm there. He converses with them all. While he's lucid I engage him in conversation about the benefits of living in the same place for so long. He agrees and is "present". Then, all of a sudden, he will start in on that house moving thing again.
One day, when he was getting agitated, I took his arm and I said "Do you feel safe here?"
He said "Yes!"
I said," then, maybe that's what's important."
He instantly calmed down. Immediately I pointed out something else, and that conversation was dismissed.
Here's my real question. What if I got the plans from the City - showing his home being built where it is? I know not to argue with Dementia, I know how to join a person in the journey. But because this comes up every single day, and seems to be causing him distress, should I try to correct his thinking?
He accepts it when I tell him that the stroke he had stole some of the words he wants to say. He seems comforted by that. I tell him that, when he had the stroke, some parts of his brain were hurt, and those parts were where some words are reached. He understands this, and now he talks to me and lets the missing words just go missing. He lets me figure it out! Like yesterday - "We went to that place where we............ get everything." "Lowe's?" "YES!!!!!"
Yesterday I drove my truck and let him take me on a tour of the entire town where they live. He never missed a turn. Described everything.
So, I'm baffled. And obviously long-winded.
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Thank you all though for validating that I'm doing the right thing. I too have created faux documents, thank goodness for the computer, printer and all the things you can copy and paste! Right now I'm dealing with babies that are supposedly in her care and living somewhere in the house. Don't think a baby doll will work - she's still very 'there'. Hmmm
your experience is impressive. of course schitzo would be another ball game entirely ( in addition to dementia ) . disputing a delusion versus acknowleging and modifying it. i think were all on the same page here your opinions just seem to pack more punch.. bottom line, disputing a delusion is just going to piss off the situation.. does not work.
If you obtained the city plans, your client would almost certainly not change his belief, because it is fixed. The rational part of him is not in control of it. We had several schizophrenic women with ongoing delusions that they were pregnant, and no amount of pregnancy tests, doctor's examinations, or years-long gestations could convince them that they were not actually pregnant. Another woman was convinced she was engaged to Brad Paisley and would wait daily for him to show up and marry her. We gave up trying to convince her that this was not true and started to use it to motivate her, such as with personal hygeine. "What if Brad comes today? Wouldn't you want to have fresh breath?" This strategy worked great until the day she informed us that she and Brad had broken up so she no longer needed to brush her teeth:-).
For stuff that I want her to have access to, I finally started putting things in page protectors in a binder with 'Anne's Notebook' on the front. She hasn't yet figured out the page protectors have an opening at the top, the binder spring is too stiff for her to work it, and the binder is big enough so that it's usually pretty easy to find.
And yes, I know I'm going to hell for lying to my mother:-)
Soon that wasn't enough. So for two years now our house has been on stilts in her mind. She made up a conversation that she had with the foundation/floor workers as proof they needed to come back. Poor guys! She kept calling them until finally I hid their calling card from her and told them not to come unless I called.
Every day we have "the conversation" about the floor and how we need to call the foundation company. I tell her the floor is fine and she gets mad at me. It has been two years, so the best I can do is deaden myself to it and keep her from making phone calls that could cost a lot of money or trouble for the unfortunate foundation workers. It is just all part of dementia for some people.
now lets get drunk and play ping pong. ( redirection / one of my favorite homer simpson lines ) .