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Alzheimer's Disease

Should I Tell the Truth or Not?

08/17/2011

Question:

As a caregiver to my 84-year old mother, I don’t know whether to go along with her beliefs that my father is alive (he’s been dead for over 40 years) and that she needs to go "home" because he will be angry. She is now attempting to leave and is getting anxious and stressed. She has been diagnosed with Alzheimer’s for 5 years. Thanks for your advice.

Answer:

Dear family: It is very common for a person with Alzheimer's disease to think that a deceased loved one is still alive or that they need to "go home." Over time, their short-term memory deteriorates and they will often bring up long-term memories of long ago; where in your case your father was still alive. Most likely, your mother will continue to forget that your father passed away years ago, so it can be hard to keep reviewing this with her.

Some individuals will not become upset when they hear the news about a deceased love one, but others will. If the person does not get upset when the subject is brought up, families can sometimes just gently repeat that the loved one is gone and that the Alzheimer's person is safe with the family member in their new home. If your mother would be emotionally distressed by hearing repetitively the news about your father, then it's better to enter her reality and acknowledge her thoughts & emotions and reassure her that your father knows exactly where she's at and that you will take her to see him in the near future, just not that day.

Often it helps to implement good redirectional strategies to try and change the conversation or get the person involved in an activity to help divert their attention elsewhere, and in your case off your mother's thought of needing to go home. "Home" is usually an elusive place in the person's past and often they cannot tell you exactly where it is; it can represent the fact that the person is progressively more disoriented and cannot recognize familiar surroundings.

An additional consideration, is to talk to your mother's doctor about prescribing an anti-depressant medication, if she's not on one. This type of medication can help reduce her anxiety and worry about needing to go. This type of medicine would not improve her memory, but may reduce the emotional distress she has about not wanting to make your father angry.

To help keep your mother safe, I would advise looking at devices to alert you that she may be headed out the door. Simple door threshold alarms can be effective and less expensive. The National Alzheimer's Association and Medic Alert have teamed together to provide a program called Safe Return, which provides an ID bracelet the patient wears; if patient becomes lost, people can locate the patient's caregiver by calling the 800-number on the bracelet.

Good luck and remember to take care of yourself too, caregiving is hard work!

For more information:

Go to the Alzheimer's Disease health topic, where you can:

Response by:

Rebecca A Davis, RN, LISW Rebecca A Davis, RN, LISW
Clinical Research Nurse of Neurology
College of Medicine
The Ohio State University