How do I better communicate with my mother who has dementia?

LaurieB, the real issue for Mom isn't the refrigerator and if it is working or not. She is looking for validation that she is still a part of this world and what is going on. Instead, tell her that you will call the repairman about the fridge so that we can make sure it works. Thank her for noticing that there might be a problem. When she brings it up again, tell her that the repairman said that it was ok as long as the ice is hard and cold and let her help you decide if it is or not. Take a complicated thing like a refrigerator working and make it a simple thing, is the ice cold.

Redirecting works depending on what stage of memory lost as you can satisfy questions of the moment'. Re: the fridge, I would agree, say someone is looking into it, your brother, etc or say it was fixed while she was napping, etc. Correcting her thinking will not work! So you have to either agree, deflect or say to her, why do you say that etc to validate her thoughts and allow her to express them. When my mom would hallucinate and see furniture on the ceiling I would just say oh yeah, wow. And let her just tell me about it. There is no easy answer of course but hopefully you'll find some strategies from other caregivers that you can apply. Best to you in your journey

CWillie is spot on . Just be gentle, is the best method. We battled too in the beginning, but learnt that being gentle works best. Allow them some activity even if it is 'silly stuff', they often want to feel useful, even if it makes no sense to you. They mean no harm.

Never talk to them as if they're a child...talk to them as one-on-one adult...it's too condescending and it will make them feel like something is wrong with them !!! Then the anger and hurt will start and you don't want to start that path...if they suggest something, talk to them about it. If it's not a good idea, find a good reasoning way to say it's not...don't just shoot it down...they will know if you're talking down to them...just love them over and over again; it's the disease not them...put yourself in their shoes and then you'll know what to do, say and act...it works !!! peace.... :)

Thank you so much for these answers. I have been not talking with my mom because I didn't realize I should enter her world. I spend this weekend alone with her as my husband (her favorite caregiver) is going out of town. I was so nervous about it but coming across this question I think will help me cope better. Not correcting her will take a load off my mind. Everyone is so helpful one this website. Thank you again

Redirecting the conversation doesn't always work. Sometimes though if you can get them to go into another room and then back out again, that may get their mind onto a different course. Here's an example....

One day my Mother-in-Law with dementia had to go in to the doctors office for lab work. She was fine when we left, but when we brought her home she was agitated for some time. I wasn't sure why she had become agitated after bringing her home. However, shortly thereafter I realized from her comments that she thought she was still in the waiting room at the doctors office! She was angry because she didn't understand why she was being held there, and not able to go home!

The diversion tactic I tried didn't work, which was this: Walking over to a table I pointed out her family photos and said, "Look, you're right here at home! Here's the photos of your son, your daughter and your other loved ones!" but she was so quick-witted and in a humorous way as she responded, "Oh come on, anyone can place photos somewhere!" and she didn't believe me that she was at home! Lol - I thought the photo diversion was going to be brilliant - lol - wrong!

But then, she needed to use the restroom. She had to ask where to find her bathroom, so I directed her down the hall. After she came out of the bathroom she had snapped back into the reality that she was indeed in her own home, and happier again! :-)

So if a conversational diversion doesn't work, try getting them to go into another room. :-) Lol - it may add a bit of humor to the challenge.

Type Alzheimer's Reading room. Read what he did to overcome many of the things we're reading while caring 8 yrs for his mom. I've read a lot & realize several kinds of dementia. Alz 9 yr is my hubby. First getting antidepressent chgd him from lion to lamb. Also ice cream is a good redirect idea. Don't worry when they eat it we all know this desease only goes down hill & w ice cream will relieve your stress. Rub their shoulders, head or feet helps some. Theropudic lies are stress savers. I used to write the answer to same constant questions for them to read. He no longer or hardly does that now. I don't have TV for him to watch except HGTV or talent program. I don't want tv people to be real people or bad happenings to him in his life. I was reminded by my daughter to never say remember. My hubby sometimes doesn't know who I am after 63 yrs marriage. Don't worry if they ask like he asks if I'm his sister & I say yes cause in 1 min he won't remember & im not sure he knows difference sister, wife, son, daughter. We have our wedding pic on the wall & he asks who are those people. One day, only once, he was tossing pillows to the guy in the mirror. My recommendation to all caregivers go to a support group. I go to one that meets weekly. Go at least twice before you quit thinking not what you need. Also ask your brother to keep your mom 12 hrs 1 day a wk. Helps them to really see what you go through. We must spill our thoughts to release the pressure that's what you do in support grps not on the patient. TEEPA SNOW says take 3 deep breaths before reply to release stress. I know my hubby sometimes doesn't hear right what I say & he repeats what he thought I said & I can't help but laugh as it ryms but way off. 36 hr day bok is go read. Can read or print really good "Understanding the Dementia Experience" it's 28 pgs printed. May God help you thru this crises.

To LaurieB -
There probably is no "one size fits all" solution, but as you have become painfully aware, explaining and arguing really do not work.
Short term memory is usually what goes first, so retaining any new information is not going to happen - so much for the explanation attempts.
Whatever the issue is that has popped into her head cannot be argued away. Trying to argue or reason with our mother, I could see it when brother tried - she would clam up (not really a bad thing, stops the yammering about the broken fridge or whatever!)

The responses/actions all depend on what the issue is and how important it is to your mom. You know your mom better than we ever could. Try various methods and see what works. Only she knows, but she cannot work that out. Using the fridge example, as several have suggested, pretend to listen or check it out, and then say yes I will have to call the repair man (or your brother if he is usually the fix-it guru) - walk off to check the phone book or "make" the call and then tell her it is scheduled. It will likely come up again, so repeat... Now that's done mom, how about a nice hot cup of tea! If she veers off onto another issue, get her a pad of paper and a pencil and have her make a "To Do" list for you, things for you to check on and/or fix! Then go do it and cross off each item when it is "done".

Another thing to be aware of is sun-downers. I think you said the doctor mentioned this. Typically the behaviors your mom shows with this will occur later afternoon and/or evening. She can become very obsessed with things and even OCD. I have read some people even become nasty, but in the morning, peachy sweet! If these obsessive behaviors are only occurring later in the day, this may be why. Of course she may be like this all day, and who knows perhaps some people ARE afflicted with this (S-D) all day or different times of the day, not just afternoon/evening. Read up on this topic, see if any relates to mom and if so read suggestions for softening the blow of this behavior (more lighting, possibly medications, etc).

Although the doctors cannot discuss a lot with you if you are not on the Hippa, that does not mean you cannot bring her there for appts. You say she cancels - does she *really*? Mom would SAY she was going to cancel, write it on the calendar and/or the reminder, but she would never actually make the call. On my way to get her I would have to call the Dr office and say IF she does call, DO NOT cancel!! One time it took my brother 45 m to get her out the door - every excuse in the book was used. I even tried calling her to give her good reason why she needed to go (you NEED refill of Rx and cannot get it unless they see you!!!) Still took another 20 m. :-(

As for DPOA and Hippa, sounds like mom is really too far gone to have her reassign (revoke bro, assign you, even she would even agree to it). She must be, in the atty's opinion, cognitively aware of what she would be signing. If anything needs to change (sounds like it does) you will need to petition the courts for guardianship (gives you authorization to make decisions for her) and stewardship (gives you basically POA over her financial affairs). You would need an Elder Care atty to process this correctly - it won't be cheap or easy, but more than likely, if mom has funds, the costs would be covered by her (if you need to kick in some money to get the process rolling, you should be able to petition for refund.) Also the courts require periodically reporting back to them, unlike a DPOA :-(

Anyway, it might just have to be trial and error with responses to mom until you find what works or *sigh* determine that it is because you are the care-giver (this happens all too often as well). Hope you find the magic touch/words!

I agree about the teepa snow. I have watched several episodes. I sit and say sure, looks easy for you. But that reality doesn't live here. Just like the help I pay. They come for 4 hours and then leave. My world is I live here. My shifts are not over in 4 hours.

And, you don't have to have an answer for every single comment she makes.

For Midkid58, can you turn off the TV or change the channel? Also, can she talk to the one she's worried about on the phone?

There seems to come a time when it's no longer about who's 'right' or 'wrong' about something...you find a way to deflect from continuing the discussion and redirect it to something else...I don't think there is a set time during the decline of dementia; you'll be able to tell and just try it...it works !!! It's less stressful and you'll be amazed at how you feel...as long as you know all of their needs are being taken care of, it doesn't matter anymore who's right or wrong...just care for them the best way you can and always ALWAYS remember how much you love them no matter at what stage they are in...no matter how hard caring for them is....peace :)

Teepa Snow is a person! An expert. Very insightful. I learned a lot at her conference.

It's difficult, but you should NOT say "Do you remember___?" Say, "I know it's hard to remember, but ___ ___ ___ " -or- Don't refer to memory at all, just say we did this now this; or, this is what we are going to do; etc. also, Not too many choices at once. Intstead of "Do you want this or that" say Do you want this/ yes or no? then, Do you want that/yes or no". Not 2 options at the same time. Hard to learn but it helps. Also, if Mom was frustrated about not remembering, I was honest with her. I said, "The Alzheimer's makes your brain have trouble remembering, It's not your fault, I will help you remember".

Just google and you will find out! As copied from teepasnow.com:

"As one of America’s leading educators on dementia, Teepa Snow’s philosophy is reflective of her education, work experience, available medical research, and first hand caregiving interactions. Working as a Registered Occupational Therapist for over 30 years her wealth of experience has led her to develop Positive Approach® to Care techniques and training models that now are used by families and professionals working or living with dementia or other brain changes throughout the world"

You can find many helpful videos featuring Teepa on youtube

What in the world is Teepa Snow?

Yes, arguing does not help. I know this may mean a little more work at the onset, but having a small, trained pet, is a great distraction for them, and for you. We have a small, housebroken, extremely loving and calm dog. Since we've gotten the dog, we've had many less arguments. Mom does occasionally accuse the dog of loving me more--I just stroke the dogs head and tell him, don't mind what she says. He is great company (and a constant distraction) for her during the day. All I have to do is feed and walk him--but in those walks I get the exercise I need and space from all those negative or confrontational conversations. I know pets are an added expense of time and money, but for me it is so worth it.

We are just beginning the long slippery slope of dementia with mother. She obsesses and fixates on one thing until she's hashed it out in her mind to her "satisfaction". There IS no distraction or gentle conversation. She gets upset over something and remains that way until it's made right, in her book. (Meaning you have to agree with her)

She still reads the paper, but gets all the stories "wrong". For example: my daughter lived in Houston until 4 months ago--her hubby took a fellowship position in Virginia. Now I KNOW mother "knows" she's moved, I was in Houston for 10 days helping them move and then my daughter was here with the Kiddoes and we talked about her new house, etc and how much safer she felt already, moving to VA. Ok, here comes the once in a 500 year flood. Daughter is VERY safe, as she is 800 miles away. Mother is frantic, watching the news, expecting to see my daughter and her children being plucked off a rooftop. (and yes, that was very awful and I know people in Houston, so a very scary time---even as the water recede, it will be years before it's OK) But to mother, K was still in Houston and what was I doing just SITTING THERE not calling out the Nat'l Guard to go rescue her.

No amount of delicate persuasion could get her to believe I wasn't lying to her. I didn't calm her down and I tried, believe me.

Sometimes it's something very simple and she will finally lose interest, but like this with the flooding--I finally had to leave and I am sot sure she believed me.

As far as your brother taking over--why doesn't mom let anyone else take her to the drs? I KNOW Why my mother doesn't. I just wonder in, other people's cases why theirs are the same way.
I am going to have to learn better "dementia" coping skills. My other sibs are MIA and only see her twice a year. They have no idea how bad she's getting.

We can't treat her like a child--she's just hit and miss with this dementia. There are still times when she is totally with us---but when she checks out, so to speak, it's hard.

Sometimes, just for the sake of peace, I will simply agree with her on everything. It's maybe not the healthiest approach, but it's all I can handle sometimes.

No, she is not in a home (yet). I wish.

My mother was also delusional and paranoid. Some of her delusions were based in reality. A woman in her facility in a wheelchair rolling down the hallway became a young boy on a bike who was stalking her and stealing her underwear. Sometimes I think that dementia is like turning dreams you have, and in some cases nightmares, into reality. We all have dreams that seem SO real, they can affect us for days. But we know they're dreams and if we share them with friends, because we don't have dementia, we usually have a good laugh about it. I have shared the story before about the aid who thought on her feet with my mom. When Mom became upset about this "young boy" one day, the aide told her, "Oh, he got thrown out. He's not allowed in the building any more." She validated what my mom said, and my mom never mentioned the "young boy" again. It's like when my grandson was afraid of monsters in his closet. My daughter made special "monster spray" and each night, they would spray the room. For those of us who are dealing or have dealt with a loved on with dementia, we must realize it's not their choice to be this way, and some day it might be us.

I learned, after a long struggle, that explanations & reasonings were not going to work. A battle will start which you will never win.

Your best plan of action is to just go along with what your mom says. You know the refrig is working, when she says it isn't go along with her, thank her for telling you, use fibs, letting her know it's going to be fixed. Move on to another subject, distracting her, "How about a piece of that delicious cake?"

Your goal is to avoid any agitation & aggressive dialogue & behavior. Try to remember the "less is better" rule. I know it may be difficult & sad, this is your mom, but you may find the simple "Ok, Yes, Got it," are easier. You may have to walk away, give you both a time out, to avoid anything escalating.

If the goal is to keep your mom at home & it sounds like it is, you will need help in caring for her, behavior concerns tend to worsen, old personalities are old selves & memories. You will have to find the "right fit," to help her with hygiene concerns, don't know if that's come about, but it will. Again, less is better rule, even though you want to help her, her anger & negativity will affect you as well, especially if you are her primary caregiver.

A good team of doctors is important as well. Sounds like there are health issues, so, an accurate diagnosis & the right meds for her may help. A day program, with activities & socialization may be good for her at some time. This will give you a break as well.

Dementia & Alzheimers is life changing for everyone. The more you & your family know the better going forward. Be there for each other, a family team is the best!

Blessings 🌸

I know that redirecting is the currently advised action, but that rarely worked for my parents. They would obsess on certain ideas. After a long time of trying to treat their concerns with dignity, I resorted to lying. For the fridge I would have just said, yes I think you are right, I'm calling the repair man right now. And then pretend to call. If I that brother had come to to check it, I would have had him pretend to fix it. Arguing an resaoning with my folks was worse than useless. Redirection with some who is obsessed, is more often, an exercise in futility. I

One of the best "tough love" questions I was ever asked might apply here. A lot of my conflict with my Mom (whether stated or unstated) had to do with my desire to be appreciated for doing the right thing, being there for her, being the responsible daughter, etc. Of course true appreciation is not in the behavioral repertoire of the disease called dementia. So it was a losing battle. But still I fought on like a trooper! One day someone reminded me of a question asked by a motivational speaker of years past -- "Would you rather be right or would you rather be happy?" Of course my initial response was, "yes". Followed by, "when I'm right and others acknowledge it, I'm happy - so why choose?" The answer of course is that when I'm right an others don't acknowledge it, that leaves me unhappy. I've set myself up for failure, disappointment, and resentment. So when Mom says one thing and you know another to be true, ask yourself, "If I just wanted us both to be happy and it didn't matter who was 'right', how would I respond?" There have been some great suggestions already on alternative responses that avoid the "who's right" dilemma. It is counterintuitive to most of us -- maybe because we endured years of schooling that was about being "right" or "wrong". Life is not that simple. It has LOTS of right answers. And most of them lie inside a mindset called "love". Maybe it will also help to acknowledge your love for your Mom and at the same time acknowledge your anger at her disease. Some days that works really well for me. Other days ... well, as others have said, being a caregiver is not something any of us do anywhere near perfectly. So forgive yourself, forgive your Mom, forgive reality ... and move on with an awareness that will help you see more positive alternatives with each day. This is such a wretched disease, and the fact that we even TRY to deal with it positively is pretty heroic. So pat yourself on the back, try to turn it into a game (the purpose of which is to enjoy the creativity) rather than a contest (the purpose of which is to win). And bless your heart - and your Mom's.

I faced a similar situation with my foster dad and it took a while to get him to come around but he finally did. However, when the same topic came up again, I was back at square one so it's actually an endless cycle. What was really aggravating though it's feeling like a broken record and having to keep repeating myself over and over and over to the point I eventually had to self-discipline and start taking different action by just not responding. I also don't do well with hearing impaired people, this is actually for me to be the most frustrating because repeating yourself raises my stress level so when someone keeps asking you to repeat yourself, I very quickly come to a point of just saying "nothing" or shaking my head  because I won't keep repeating myself like a broken record. Eventually they get the hint the problem is with them and they need to take care of it. I faced this with two people so I do have some experience with hearing impaired or people who just don't "click". 

They say you can't reason with these kinds of people, but I hate to differ because to some reasonable degree when they happen to have a spell where they're in their right mind, I must say from experience, yes you can. They may forget the conversation, but they eventually come around again and somehow remember. I speak from experience because I had the experience of my foster dad before he was eventually put into a nursing home following some events

I think it helps to understand what functions of the brain is being affected and how that will make behavior manifest itself. There is a person named Teepa Snow who has been working around and studying dementia for 30 odd years. She is with the Pines of Sarasota Education and Training Institute. She travels all through US and Canada giving lectures for Caregivers for people with dementia. You can find lots of video clips of these on YouTube and she goes really in depth on why dementia causes people to behave as they do from the different types. She does alot of roleplaying, I would imagine pretty accurately, of dementia behaviors and how to connect with that person who's area of awareness has been drastically reduced by the disease.

This two-part video may be a good place to start. Teepa talks about communication with dementia patients and gives pretty good demonstrations.
WorkSafe BC How to Approach and Communicate with someone who has Dementia https://www.youtube.com/watch?v=b1KUM2Db8Bs

Join her on her journey. Agree if appropriate, if she is off base ask questions to help you find a way to redirect to another topic.

If you want to have access to her health information you need to be listed on the HIPPA form required of each patient. It identifies who is allowed medical information regarding a patient. Your mother or your brother can add you to the authorization form.

Each doctors office and hospital requires this form. It would be good for you to be added just in case your brother is on vacation, can not be contacted or is unable to take her to the doctor or hospital in an urgent situation. If your brother is so over whelmed might he be willing to relinquish POA if your mother is willing to reassign it to you?

Finally, you sound like you need a break. Perhaps you could go on vacation? Could someone else stay with her? Some memory care facilities offer respite care so she could stay there a few days or a week while you are gone.

Be sure you have friends you can vent to, it is so helpful in alleviating the pressure. On really difficult evenings when I was afraid my patience would break and I would become unpleasant, I would have a drink or two to lower my stress level. Also I found walking a couple of miles a day helped me be more patient and less stressed.

Keep your chin up. Out of love you have taken on an arduous, thankless task. That makes you a special kind of person.

We all feel the need to be appreciated. I don't know how I am managing and I don't care - all that is important is that I am managing.
One day at a time and go look in the mirror. If you're doing the best you can, no one can expect more.
Next time with the fridge - tell her it's coming next week! Describe it if you want - God will understand and forgive that small lie.
Tell her about all the extras in the new fridge, like ice from the door! If she says she doesn't want some "extra" tell her you'll cancel the order and get another one. It really won't matter unless, God forbid, the fridge really does go out.
You have to learn to pick your battles and let the rest go. No, it's not easy.

Talk to them like they are a child. If she doesn't like your response just change the subject. Keep them on their toes. Talk silly and it will help with your own sanity. You need to stay mentally/emotionally healthy so you can continue to help. Do not let the patient get you down. You are in the driver's seat so take control. You need to not take things personally. You are doing the best you can. Or are you not? Stop second guessing yourself and take control. You are the best. Not everyone can do what you are doing. Be strong!

Our mother is so high wired and honed in on her chosen subject distraction does not work well. We do try the other approaches mentioned here as far as entering into her reality and it works some. But the idea or suggestion that we agree with her did not work in our case. Specifically if her questions were shrouded in suspicion or paranoia, agreeing with her only intensified her fears and obsessions. We learned that quick! Try very calmly and sincerely posing a reasonable, yet benign question back to your mom on the subject she is concerned about, and give her a chance to answer. But, be careful, you can become a slave to these conversations. You may have to slyly introduce new happy subjects. 
I combat the temptation to surrender to the negativity by doing, and talking. Do the dishes and talk, talk, talk. Vacuum, mow the lawn, etc.. Try saying, "let's clean the fridge out, that may help it cool better". I keep busy to deflect much of the obsession and negativity. Arguing doesn't work. The few times I felt I argued or spelled things out clearly, it seemed to work well.....for five minutes. 
Now that's just my approach.  My sister has the ability to just sit and listen well and  to stay neutral. We all have own own way, I hope you find yours.

Some music therapy might make life more bearable. Try singing or playing some of her old favorite songs. All the better if she can sing to them.

Laurie B -- Although you don't want to put your mother in a nursing home, you may want to start gathering information about how to select one, cost, Medicare eligibility etc. When hospice urged me to put my husband in a nursing home, I didn't think he would be eligible for Medicaid assistant, but he was. The nursing home took his Social Security check, but that was all.