For those of us who have loved ones who are living with dementia, every single day can present problems, for which there seem to be no answer. Often, as our loved ones progress in the disease, they'll look for people or places that are simply unavailable. A relative who has passed away long ago, or a house in another state or part of the country. The desire to talk to these people or visit these places can create anxiety, distress, and paranoia. This is especially true if the answer is constantly "no", or they're told that the person has passed away, or the house has been sold.
It's important to understand why these 'problems' are happening in the first place. As dementia progresses, regardless of the diagnosis, the physical matter of the brain is affected. The disease causes affected portions of the brain to wither and die, effectively shrinking the brain over time. Often, when talking about dementia, we'll say that someone has 'forgotten' some piece of information. In fact, the part of the brain where that information was stored is simply no longer there.
As this process happens, those parts of the brain that are readily accessible become places of comfort and safety for our loved ones living with dementia. Those memories become all-important, and, in fact, shape the reality that our loved ones live in every day. Your mother hasn't forgotten that your father died - in her mind, he never did. Your grandfather hasn't forgotten that he sold the lake house years ago - in his mind, he still lives there.
We like to refer to these things - the memories that remain intact as dementia progresses - as 'cognitive anchors'. Memories in the brain that stay present while others are lost.
Understanding the problems that face our loved ones living with dementia is the first step in helping them to solve them. Often, I'm told that people feel badly about 'lying' to their loved one. We must understand, it is our knowledge of the way things are that make this feel as if we're doing something wrong. To the minds of our loved ones living with dementia, we're simply participating in a conversation about the way they know things to be.
If you're finding that your loved one is frustrated, agitated, or paranoid around conversations of current events, it's a good time to start asking questions.
Do you know where you live?
Do you know who you live with?
What did we do last week?
Asking these types of questions will help to give you some context of the reality in which your loved one is living, and can help you frame requests or conversation around cognitive anchors that will make them feel comfortable and safe.
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