Apr 24, 2016

Alzheimer's Dementia Accusations and Fractured Fairy Tales

The natural tendency for most Alzheimer's caregivers is to try and explain, and sometimes in a heated fashion, that we did not do what we are being accused of by a dementia patient.

By Bob DeMarco
Alzheimer's Reading Room

It is not unusual for Alzheimer's and dementia patients to make false accusations.

It is not unusual for Alzheimer's and dementia patients to make false accusations.

For example, it is not uncommon for dementia patients to say someone is stealing money from them. It is also fairly common for women living with Alzheimer's to guard their purse. Even to take it to bed with them at night.

It is one thing when a dementia patient accuses someone else of stealing, and totally different when they accuse you, the primary caregiver of stealing.

Somehow we don't get as upset when someone other than ourselves is being accused. However, when we are being falsely accused we have a need to defend ourselves, and our reputation.

Have you ever been falsely accused by someone suffering from Alzheimer's? Join the club. It does happen to most of us.

The natural tendency for all of us is to try and explain, and sometimes in a heated fashion, that we did not do what we are being accused of by the dementia patient.

So we go on and on defending ourselves, and trying to correct the patient. Does this strategy work effectively? Or does it make matters worse? Let me try. It makes matters worse.

When a person living with dementia believes something to be true it is true, and nothing you can do will convince them otherwise.

If it is unlikely that you can convince them otherwise, why do we, the caregiver, continue to try and convince them otherwise over and over? Are you good at convincing a person with dementia that they are wrong, and it never happened?

Let's talk about my mother's dolls.

For years my mother would accuse someone, not me, of stealing her dolls. I knew that no one stole her dolls, and in fact I knew what did happen, she gave them away. I admit for the longest time I tried to explain to her that the dolls were not stolen; and that, in fact she gave them away.

Did this defuse the situation? No, in fact it made her more unhappy, more confused, and harder to deal with. This usually resulted in us having another rotten day.

I started trying to figure out where these accusations where coming from.
I gave this considerable thought - for about 2 years. Here is what I concluded.

It seemed to me that Dotty would look over to the place where her dolls had been (lets say about ten years ago). She didn't see her dolls. She didn't remember she gave them away. So she had to make sense of the situation.

She didn't see them. They weren't where they were supposed to be. She didn't give them away. So she came to the only logical conclusion possible.

Someone stole her dolls.

Finally I realized her conclusions made perfect sense for a person living with Alzheimer's. In Alzheimer's World.

I began to deal with the problem of accusation by thinking of my mother's brain as being "fractured" by dementia.

She remembered the dolls, so that piece of information was still rolling around in her brain (long term memory). She knew where she kept the dolls, so that piece of information was rolling around in her brain (long term memory). However, she couldn't see or find the dolls, so there was only one logical conclusion - they were stolen (short term, lack of new memory). How she decided who stole them really was a matter of trust. She accused the person she trusted the least of stealing them.

I began to think of her accusations as fractured fairy tales (think Rocky and Bullwinkle).

Thinking of her accusations as fairy tales made them a lot easier to accept that it was when I was thinking of them as - accusations. This was especially true when I was the one being accused.

Thinking of myself as a character in a fractured fairy tell was much easier to digest and accept. After all, all I really was in these fairy tails was a cartoon character of sorts.

Some of my mother's wildest and craziest fractured fairy tales now seem very funny to me. They were not so funny when they first occurred however. They usually made me feel angry.

Here is one fractured fairly tale my mother told for over 4 years.

She claimed that my brother came for Christmas. He came in and somehow I made him mad, so he turned around and went right back home. It was all my fault that he left.

Consider this. My brother lives in Philadelphia, and we live in Delray Beach, Florida. Does it seem plausible that he took an airplane flight 1250 miles, walked in the door, got mad, then turned around and took a plane right back home?

Every single person my mother told that story too over a four year period believed it. In fact they asked me, what did you do to make your brother so angry that he went right back home?

Fractured fairy tale? Of course.

What actually did happen was my mother talked to my brother on the telephone on Christmas day. Later all she could remember was that she talked to him. It seemed to allude her that she talked to him on the phone.

So. If she talked to him (in person) and he wasn't there, he must have gone back home. Why did he go home? Well the only logical conclusion she could come to is that I must have done something to make him leave. So, I was mean to him and he left. No, she didn't blame herself, she didn't blame him, and yes she did blame me. I became the villain in this particularly fractured fairy tale.

Alzheimer's patients are really good at piecing together these fractured fairly tales.

If you take the time to examine all the pieces of a tale you will soon notice that all the pieces come from a particular place, time, or memory. They take a piece of memory from one time and place, another piece of memory from another time and place, and then they add in the accusation which makes all the different pieces logical and understandable. They need to add the accusation because there is no other way for them to make sense of the story. Don't take it personally. They are doing the best them can with a memory that is fractured.

The part I liked best about my mother's most vivid fractured fairly tales was that they were always more believable than that truth. Dotty was one great fractured fairy tale story teller.

People old and new always believed her fractured fairy tales. After a bit, I started relaxing, looked at the face of the person she was telling the story too, watched as they became all amazed and often animated.

I guess you could say, the joke was no longer on me or my relatives.

So I learned to accept Dotty's accusations as fractured fairy tales. Tall tales that were fascinating in their component parts. Little pieces of information that were rolling around in her brain all molded together to make sense, and then used as the basis for the sometimes ugly accusation.

The brain is quite fascinating.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob lives in Delray Beach, FL.

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Extra -- How to Listen to an Alzheimer's Patient