Painting the Fence – Using Therapeutic Reasoning to Ease Anxiety

“.We’ve all felt that sense of nagging anxiety when we know there’s a task left undone that we haven’t quite tackled. Whether it’s a lightbulb that needs replacing, a lawn that needs mowing, or a tap that needs fixing. In the case of ‘Susan’ and her husband ‘Jim’, it was a fence that needed painting that kept bothering Jim. Though in reality the fence didn’t require painting. Jim, who has vascular dementia, kept insisting it was necessary. In his mind, it was an unfinished task that needed to be completed. The more he obsessed over it, the more anxious he became, and the more stressed Susan felt.

To ease Jim’s anxiety, Susan tried reasoning with him, explaining that the fence was fine as is. Jim however refused to budge and would get even more upset at Susan for contradicting what he perceived to be true. She wondered whether it would be best to allow Jim to try and paint the fence himself. But she was worried about Jim taking on a chore that she knew he wouldn’t be able to handle due to his condition.

CHANGING THE APPROACH

Susan understood that, instead of a paint job, a change in approach was what was needed instead. So after attending a caregiver support group in which she heard about a strategy called “Therapeutic Reasoning”, she decided to give it a try. Susan put herself in Jim’s shoes and understood that the issue about the fence would continue to weigh on him if she continues to dismiss his concerns or attempt to change his mind. When Jim brought up the topic again, instead of negating his worries, she agreed with him and told him, “Yes, we’ll definitely get that done, but not right now because winter will be coming. So let’s do it first thing once spring arrives.” Even though it was the middle of summer, Susan knew Jim would not fully understand what time of year it was and that it would help relieve Jim’s concerns for a few months.

THERAPEUTIC REASONING

Using Therapeutic Reasoning, a strategy that involves entering the reality of the person with dementia instead of trying to challenge them, Susan was able to put Jim’s mind at ease with some reassurance and in doing so found greater peace of mind for herself.