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An Approach You Can Try When the Past Makes More Sense than the Present

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A Therapeutic Approach

Helena and Gerard have been married for over 70 years. They met when they were very young back in the Netherlands. Gerard was a handsome young soldier; Helena was a beautiful young Dutch woman with a sweet smile.

Their love story began when young Helena and her friend stepped outside the restaurant where they worked, for a smoke. They realized that they ran out of cigarettes when this handsome soldier passed by and graciously offered them some. They had an immediate connection, and the rest is history.

 

Alzheimer’s Disease and Getting Stuck in the Past

Fast forward to 2010 Helena was diagnosed with Alzheimer’s disease. Helena’s Alzheimer’s manifests in a way that keeps her memories of the past vividly. Helena’s daughter Miriam, notices that her mom keeps going back and talking about the past. 

One evening, Miriam saw that her Mom was agitated seeing a “man” in the living room that she didn’t recognize and insisted that he leaves. Attempting to calm mom down, Miriam said, “Mom, he’s your husband. My Dad,” thinking this would help but it didn’t.

Then, Miriam realizing her Mom’s pattern of repeating stories of the past from decades ago, tried a different approach. She said, in an excited tone, “Helena, he’s your boyfriend, the soldier. He’s waiting for you.”

To Miriam’s delight, it worked! Hearing the words, “your boyfriend, the soldier,” Helena reacted in a sheepishly cute way and was instantly carried back to beautiful memories of when she met her now husband. Recognizing who he was, Helena rushed and gave “her boyfriend” a big hug!

 

Therapeutic Reasoning™ and Doing Whatever Works

Therapeutic Reasoning™ is a communication approach that’s about putting ourselves in the reality of the person living with symptoms of dementia. Alzheimer’s disease is the most common form of dementia and in Helena’s case, it kept bringing her back to memories of the past, specifically, more than 70 years ago.

As a Dementia Consultant, I have often given the onion an analogy to what often happens to someone living with certain types of progressive dementias. Visualizing an onion and the outermost layers being recent memories; as time goes by, the outermost layers are peeled away until eventually, the person will have stronger memories of the past (centre core of the onion) than they do of the present.

Some people who are new to supporting someone with dementia feel uncomfortable with this approach as they equate it to lying. However, there is a science behind Therapeutic Reasoning™ as demonstrated in Helena’s story. Trying to “reason” and bring her to the present reality may not work and would only cause her and the people caring for her more stress. However, if we take the time to understand and see things from their world, we can create an environment of peace for the person we are caring for to feel safe and support their well-being.

 

This story is based on a real client’s dementia journey although the names and details have been modified to preserve confidentiality and protect privacy. Our “Meaning Behind the Behaviour Stories” are meant for informational purposes and to share best practices in dementia behaviour management. Each person is unique and what may work for one person, may not necessarily work for another. 

If you are in need of advice on understanding ways to have successful interactions with the person you are caring for, contact us for our no-cost 20-minute phone or Zoom consultation for new clients. 

Whether you are a family or professional caregiver, keeping ourselves informed and educated about dementia allows us to better support the person we are caring for. This July we are offering a Summer Sale on our self-paced online dementia courses. Please visit our website at www.DementiaSolutions.ca to take advantage of this month’s special discounts.

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