East Bay CNA from Hillendale Home Care is licensed by the State of California to provide Certified Nursing training courses for Contra Costa and Alameda Counties.

Archives for November 2020

When Dementia Confusion Leads to an Alternate Reality

caring grandson and his grandfather outside

Dementia confusion can cause seniors to believe they’re living in an alternate reality.

Dementia confusion, a prevalent occurrence in Alzheimer’s, can lead to recent memories being forgotten or altered, while those from the more remote past often continue to be unimpaired. This may cause a past period of time to make more sense to an older person with dementia than the present. A person’s alternative reality may be his/her way of making sense of the present through past experiences.

Seniors with Alzheimer’s disease frequently have problems expressing themselves, and sometimes their alternate reality has more to do with a need or a particular feeling they are attempting to express than it has to do with the words they are saying.

For example:

  • “When is my wife going to be coming home?” This question might be more about the need for affection or acceptance or a home-cooked meal than about wanting to see his wife, who passed away many years ago. An effective reaction to discover more might be, “Why do you want to see her?”
  • “I need to bring all these casseroles to the neighbors before the end of the day.” Despite the fact that these casseroles do not exist, the words may represent a need for meaning and purpose in the senior’s life, or the desire to be engaged in an activity. An appropriate response to learn more could be, “Why did you make casseroles for the neighbors?”

Maintaining a log of these types of events may help you identify a pattern in the person’s dementia confusion. The more you listen in and pay close attention, the easier it will be to recognize the thinking behind the alternate reality and the ideal way to act in response.

Is It Appropriate to Play Along?

Providing the situation isn’t going to be dangerous or unacceptable in some way, it is perfectly fine to play along with the senior’s alternate reality. Doing so is not going to make the dementia worse. Keep in mind, the senior’s reality is genuine to him/her, and playing along can make the older adult feel more comfortable.

If the scenario is inappropriate or may possibly cause harm to the senior, try to react to the perceived need while redirecting him/her to something safer or more appropriate.

Keep in mind the following 3 steps:

  1. Reassure the senior.
  2. React to his/her need.
  3. Redirect if required.

Hillendale Home Care, leaders in home care services in Walnut Creek and surrounding areas, helps seniors and their family members navigate through life with dementia. Contact us to learn more about our professional in-home care services, or to join our care team through our CNA and HHA school.