Let Us Not Reason

"I've told her time and time again not to put things in the waste paper baskets, but she doesn't listen."

"He tells me he wants to go home. We've lived here for thirty-five years, and I try to explain that to him, and he gets mad at me."

"Mom and I used to go 'round and 'round about what day it was. I'd get so involved and finally we'd both sit down and cry. "I can't help it," she would say. Then we'd both laugh and say we'd take turns crying...today is my turn."

We have a hard time letting go of the old habits of reasoning with our spouse, parent or friend who now has Alzheimer's disease. It is important to keep in mind that the real deterioration of brain tissue is the cause of apparently irrational behavior. The victim is not behaving this way to annoy or irritate you, in fact, they are probably unable to consider the impact of their actions on others. It is never going to work to "teach" the woman not to hide things in the waste baskets. Instead we must teach the caregiver to accept this behavior as harmless and to check the waste baskets before emptying them.

The woman whose husband wanted to go home learned that she only frustrated both of them when she tried to "explain" that they were at home. Rather what worked was, to go outside, walk to the corner and back. Upon entering the house a few minutes later, the husband was content. This is an important lesson for the caregiver; there is no reason why the victim's reality has to conform with ours. Another caregiver told me of the time her husband woke her at midnight. "Let's go to San Francisco," he insisted. Rather than explain to him the reasons why this wasn't a good idea, she said, "All right, but would you like some ice cream first?" After that, they turned on the television, and were eventually able to return to sleep. His lack of short term memory actually worked to her advantage.

It sometimes helps to become a co-conspirator. Perhaps you have hidden the keys to the car and Dad wants them. Instead of explaining why it isn't a good idea for him to drive, you might seem perplexed by the missing keys and agree to help look for them. After a couple of minutes, suggest that, "Well, we'll find them, but lets sort these clothes right now. We really need to get this done." Wait for an opportunity to redirect. Talk positively about the future.

Support groups talk about: how to agree, defer, redirect. Don't: confront, argue, reason.

You will never win an argument with an Alzheimer's person.

--Clinical management of Alzheimer's Disease, edited by Ladislav Volicer, MD, PhD, Kathy J. Fabiszewski, RN, MS, Yvette L. Rheaume, RN, BSN, and Kathryn E. Lasch, MSW, PhD. Aspen Publishers, Inc. 1988

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