Correcting a dementia patient can be harmful | Alzheimer’s Blog

When I was very young (about 2 years old), one of my best friends was a boy who had a small speech impediment, common to children of that age.  With his particular impediment, he couldn’t pronounce the “sp” sound.

As a result, a word like “spaceship” came out “bayship.”  Being the stubborn boy I was (a trait that hasn’t completely left me after 31 years), I insisted to my parents that indeed, the word was “bayship.”

My mother kept trying to correct me, explaining that the word was “spaceship.”  Whether or not she was successful, G-d bless her for trying.  As the mother of a two-year-old, that is a parent’s job.

I suppose, then, that it is quite ironic that 25 years later, both my mother and I would be thrust into a situation in which the idea of correcting improper statements was not only the wrong thing to do, but in which can be destructive as well.

That situation?  When my family purchased five residential care facilities for the elderly, specializing in the care of individuals with Alzheimer’s disease and dementia.

One of the central tenets of dementia care is that you never correct an individual when he or she says something inaccurate.  Unfortunately, so many family members, caregivers, and administrators do not know this or simply don’t care.

The classic example is the Alzheimer’s resident living in an assisted living facility who scolds his or her child, saying “You never visit me!”  The frustrated child responds, “I visited you yesterday!”

When Alzheimer’s disease afflicts an individual, the plaques and/or tangles that make up the pathology of the disease begin to damage and eventually destroy neurons and synapses.  In effect, the brain’s ability to perform basic functions, discern basic information, etc., is destroyed as well.

In other words, it’s not the individual’s fault.  His or her brain is literally incapable of discerning truth from fiction.

In fact, correcting a dementia resident can actually be harmful, especially to those residents still in the early to mid-stages of the disease.

During these stages, patients may be cognitively aware enough to understand what is happening to them.  Correcting them can cause frustration or depression, both of which can exacerbate the dementia and accelerate its progression.

Caregivers need to learn how to address incorrect statements without correcting the resident, and they need to learn how to redirect a resident, especially when that resident is agitated.

I know no better expert than my mother, and I can vividly remember an incident that occurred shortly after we took over our facilities.  What I remember most was watching her in amazement.

Our resident (we’ll call her Jane) was extremely agitated.  While in her room, she began screaming, “Get away, get away!”  Even the caregivers could not calm her down.

My mother entered her room and asked Jane what was wrong.  Jane explained that she was being chased.  At this point, my mother could have chosen to tell Jane that she was wrong, and that she wasn’t actually being chased.

Rather, she chose to agree with her.  In fact, my mother then asked Jane if she would like her to call the police.  Jane’s response was that the police are useless and that they wouldn’t do anything.

Once again, my mother could have corrected Jane.  Once again, she knew better.  My mother knew that Jane liked to feel in charge in any number of situations.  (She actually thought that she owned the house and that the other residents were her tenants.)

My mother responded to Jane by saying that if she (Jane) were in charge of the police department, they would be much more reliable.

“Of course they would!” replied Jane.  The two of them proceeded to have a ten-minute discussion about how Jane could improve the police department.  Most importantly, Jane completely forgot that anyone was “chasing” her.

This should serve as a model of how to avoid correcting a resident, and how to redirect that resident.  Had my mother chosen to correct Jane, Jane would have remained agitated and would have refused any sort of care.

By agreeing and redirecting, my mother was able to calm her down, get her to allow the caregivers to enter the room, and most importantly, set the right example for our facility.

It should be an example for caregivers everywhere.