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how do you handle a dementia Alzheimer’s patient who thinks they’re being followed or that someone wants to kill them so they won’t leave the facility to go visit family or anything how do you talk to them to let them know that their fear is not reality? Or do you just leave them be if they’re content?

i meant irrational fear. they are making it up
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waytomisery Jul 22, 2024
It’s real to the person who is experiencing it . They aren’t making it up to avoid leaving the facility . You can’t reason with them . Leave them be if they are content .
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You can’t reason with them . They have a broken brain . They will not understand that “ their fear is not reality “.
Let them stay at the facility where they are comfortable . It’s very common for them to eventually be uncomfortable leaving . Visits will have to be at the facility . They often have a family dining room for this reason that can be reserved if for example family wanted to bring a meal , birthday cake etc .
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You can talk to their primary doc or neurologist about whether meds would help with this.

I agree with waytomisery, dementia robs them of their reason and logic and therefore it is pointless to try to convincen them of anything.
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Reply to Geaton777
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First you talk to their doctor about getting them on some medication for their paranoia which is very real sadly to them and until and when that gets under control, I would just let them be since they seem content.
And for God's sake DO NOT try and reason with someone whose brain is broken.
You'll end up being the one going crazy.
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Reply to funkygrandma59
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You cannot reason with a person who suffers from Dementia. Like any paranoia, the person believes it. If the person does not want to leave the AL then don't make them. They will not enjoy the visit anyway. Family comes to them.
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Reply to JoAnn29
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You leave them be if they are content. There's no reasoning with dementia. There's no concepts of reality or logical thinking with these people. Sense has left the building.

If a person with dementia is paranoid and flipping out in terror all the time, they need to be medicated. Anti-anxiety meds even anti-depressants can help with that.

Yes, you talk to them. If they are going on about people following them and trying to kill them you tell once or twice that it's not true then let that be the end of it. Do not validate their delusional nonsense or give it any attention whatsoever. The same thing when someone is in a dementia loop and repeating continually. You don't keep answering the same question and explaining the same thing hundreds of times. You answer or explain once or twice, then do not participate in any more discussion on that topic.

Try to redirect them onto another topic or activity. If that doesn't work end the visit.
Don't worry about them refusing to leave the facility. Clearly they feel safe in the facility and that's good. Don't take them out then. They will not enjoy going out. With dementia any disruption in the daily routine can cause setbacks in whatever level of independence they still have and it will cause increase in the delusions, anxiety, and agitatation. This will only make the job of whoever has to take care of them harder than they already are. Don't take them out.

Family who wants to visit them can come to the facility or visit through videocall. That's the best way.
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Dawn88 Jul 22, 2024
Spot on as usual. Make it easy and fun with free ZOOM software.
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How, exactly, is this person "content" thinking they're being followed or that someone wants to kill them? Speak to their doctor about calming meds to help this poor person, and don't worry about taking them out or talking to them about your reality vs. theirs. Pick up a copy of the book Understanding the Dementia Experience by Jennifer Ghent-Fuller on Amazon so you can learn about dementia and how to deal with this person properly.

Good luck to you.
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waytomisery Jul 22, 2024
I took it as they were content and not having those fears so long as they weren’t asked to go out or taken out of the building . Some believe they are safe so long as they don’t leave .

I agree if they have these fears all the time to get them calm with meds .
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Unless a medication works to calm my mother, she will spend all her final time in her room at the care home. She is content there, and panics if we take her out. Last time we took her around her quiet, pretty neighbourhood, she was certain snipers were after her.

A family friend developed the same mindset.

No more outings. You have to go to them.
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I think your loved one might just feel safe in those for walls she is living in.

Sounds a little like agoraphobia, issues like hoarding and what not can intensify with dementia, so I imagine other issues can too.

Weather or not you want to medicate them, to get them out is up to you, as for knowing what is best for them.

If it was me and they felt safe and happy where they are, I'd leave well enough alone.

You are so lucky not to have them complaining and crying that they want to go home at every visit
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waytomisery Jul 22, 2024
“ You are so lucky not to have them complaining and crying that they want to go home at every visit “ .

This says it all .
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After going through 100 hoops to get a demented Elder placed in a facility, which they actually adjust to and feel content and safe....
Why on earth would you want to drag them out somewhere for a family visit???
Let the family come visit THEM.
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waytomisery Jul 22, 2024
This ! What Dawn says .

Unfortunately some families are programmed to try to keep them doing “ normal things “ when they aren’t normal anymore .

It’s part of the mindset of our society to fight aging , and keep doing .

My sister in law brought her mother ( who had Alzheimer's) and did not recognize anyone to my mother’s wake . The poor woman looked like a deer in headlights. The woman kept asking to go back home ( to her assisted living ). My sister in law kept telling her who people were . The woman just wanted out of the funeral home .
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Fear, anxiety can be helped with medications but there are drawbacks.
Now I have to ask WHY would you want to take them out of their home, the Memory Care facility is now their home, and bring them anywhere?
They probably didn't want to go into the facility to begin with, they adjusted and are now so comfortable that this is their "safe place".
To take them back to what might have been their home or to anyone's home is upsetting. Not to mention it will be noisy, confusing, different people.
If you want a gathering do it at the facility. Most have a room reserved for gatherings. And I would make it a small group or encourage people to visit and leave. If you want to get together with family do so but leave you LO where they are comfortable and safe.
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Reply to Grandma1954
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This requires a medical consult. They may be medications to help. I am so sorry you are going through this.
Meanwhile, don't argue, keep the elder in an environment where he/she feels safe as much as possible. Contentment, yes, is your goal. A feeling of safety should be provided to the best of your ability. However, there will be times when a medical appt or some other issue requires transport from a place of safety. Provide comfort to the best of your ability, and do consider anti-anxiety medications when needed. Best of luck.
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It is very difficult watching your loved one experience the many facets of dementia. Medication helps. I struggle defending the workers to my mom. She thinks everyone hates her and she is turning into a racist. It's awful! Good Luck!
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Reply to Onlychild2024
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So along the Rockwell song "Somebody's Watching Me"?
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LakeErie Jul 27, 2024
Very odd answer.
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Have visitors visit THEM one at a time with you or someone they are not afraid of. DO NOT LET PEOPLE SWARM IN ON THEM! The ALZ patient does not know anything - they have regressed back to where they know nothing and to have a bunch of people come into their safe place will scare them. Introduce the visitor as if he has never met them before and if the patient says I know who that is... then play dumb - ah I forgot you did or I'm just teasing. They need to keep things the same.
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Reply to Ohwow323
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Leave the patient, your relative, or whoever it is alone and do not take out. Visit instead.
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Reply to Patathome01
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What is the reason to have a person with dementia leave the facility to visit family?
* They won't know (or remember) who these people are ...
* They undoubtedly will experience increased / more fear and confusion.
* You do NOT want to change a person with dementia their immediate environment - it causes confusion, distress, overwhelm.

I presume that your desires are well intended although you do not understand what dementia is and how it affects a person's brain / behavior / cognition.

Communicate in ways that keep them as calm as possible.
All paranoia is irrational - ? (Well... on second thought, perhaps not.)
It is part of dementia and how the brain chemistry changes.

You do not 'let them know' or try to explain that their fears are not reality because they cannot understand rational thinking / cognitive deduction.
When a person has dementia, thir brain changes; they lose their brain cells.

You want to communicate mostly by:

- voice / tone / intensity (soft, quiet)
- facial expressions (smile) / show reassurance

- Say short sentences or a couple of words

"Yes, I understand" ...

"okay, I will take care of it. ...

'you are safe now ... "now" as the person will always be in 'present' time / unable to process information.

Touch - be it massage or hand holding. Offer reassurance as it is accepted. Try gentle touch.

Read Teepa Snow's website, webinars, You Tubes, books.
She explains what dementia is, the parts of the brain and how they function, what parts / cells die with dementia, how to communicate with a person inflicted with dementia.

Consider / discuss with facility / medical providers medication management to see if the hallucinations can be managed.

Get a sitter and/or volunteer to keep the person company / reassurance.
Even a few hours a day will help.

You need to educate yourself in order to keep your loved one and yourself as calm as possible. You can only do so much. This (writing us here) is a major first step. Thank you for reaching out.

NONE OF THIS PROCESS IS EASY. It is grief filled and difficult, even for the best of us working in the field for decades. Every person presents a new situation to manage / respond to ... we learn by understanding dementia, showing compassion, having patience, if something we do doesn't work, we try something else.

Gena / Touch Matters
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Vanessa8686 Jul 26, 2024
I was just introduced to Teepa Snow's resources during a caregiver support group this afternoon. Looking forward to digging in and hopefully understanding more.
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Aside from regular medication -
well if the fear occurs with leaving, try to avoid leaving at all costs. Sometimes you can get doctors, dentists to come see in the AL.
have guests come to visit.

If there are reasons where he /she has to leave, see if doctor will allow an as needed medicine for those days?
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Reply to strugglinson
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Julzb50: An individual with Alzheimer's does not possess the capacity for logical thought processes. Ergo, perhaps they should not be leaving the ALF.
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Reply to Llamalover47
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Leave them be if they’re content in their safe environment. Why would you not ??
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Reply to datanp97
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The world can be scary outside what is familiar.If the person is content leave them be.Although it feels good for us to get away and do something....it might not be for them.
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