Oct 8, 2013

The Dreaded Question, Where is Mom?

Redirect is social work speak for changing the focus of attention from whatever it is disturbing them -- making them angry, fearful, anxious, or any one of the many negative emotions we human beings feel -- and directing their feelings from the negative to the positive.

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By Bob DeMarco
+Alzheimer's Reading Room

Our reader Dave asked in the comments section under the article Communicating with the Deeply Forgetful:
Need help! My wife was diagnosed with dementia 5 years ago and is 76 years old. Every day she asks "where is Mom?" Her Mom passed 26 years ago. How do I enter Alzheimer's World with that question without getting into a logical trap which she is still capable of understanding?
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Let me start by publishing Patricia Lambert's reply which appeared right under Dave's comment.
I'm looking forward to seeing replies to your question. My responses vary depending on how Mother asks the question. Sometimes, I'm able to change her question into a conversation about her parents/husband. Sometimes, she is lucid, and I tell her the truth; I prefer not to do this however because sometimes it upsets her, but sometimes it seems a relief to her because she's mad at them for leaving her here.
This is one excellent comment for sure, and an excellent example of how powerful the Collective Brain of the Alzheimer's Reading Room could be. Thanks Patricia.

There are additional comment you can read if you go back to the article.

Patricia wrote (more or less) that she looks and listens for some cues that help her decide how to deal with the question.

You never know what you can learn from a person who is deeply forgetful just by listening closely to the sound of their voice. A person who is asking a simple question will sound very different from a person who is in need of special attention.

The Truth versus the Fib

Many caregivers say they can't lie to a person who is deeply forgetful. It makes them feel bad. Let's face it, nobody wants to be labeled a liar. However, care giving is not all about the feelings of the caregiver, in fact, it is mostly about the feelings of the patient (I really don't like the word patient).

So what would be more loving and caring?

Telling a person who is deeply forgetful the truth and making them feel "horrible", upset, confused, and possibly angry just so you can feel better? Or, telling a fib knowing fully that you are in control of the situation and using a technique that is designed to deal with a PROBLEM that most caregivers face in one form or another.

Dave, I'll take Patricia's advice one step further.

If you think you can tell the truth on certain occasions without upsetting your wife try this along with that approach: take out some pictures of your wife's mom and discuss them with her. Believe it or not, over time this might help your wife to stop asking this question.

I would also suggest actively bringing up a wonderful experiences the three of you had together in the past. In other words, attacking the problem head on. Get out in front so to speak.

Most of the deeply forgetful can remember the past. And, if you bring up something with a happy emotion attached to it, they might remember the situation better than you do. Dotty really fascinated me when we discussed the deep past.

Emotion is the key to long term memory with persons who are deeply forgetful. This explains in part why contemporary music, music from when they were young, works so well with Alzheimer's patients.


One of the most popular techniques for situations like the one you are describing is called redirection.

For a description of this technique I'll turn to a comment Carole Larkin made under the article, Alzheimer's and Redirecting as a Form of Communication.
Redirect is social work speak for changing their focus of attention from whatever it is disturbing them -- making them angry, fearful, anxious, or any one of the many negative emotions we human beings feel -- and directing their feelings from the negative to the positive.

From "bad" inward to "good" or pleasurable outward.

Use the attention span limitations to work for you and your loved one. It doesn't matter what it is that you direct their attention toward, just as long as it makes them feel good in that moment.

For Dotty it can be chips, Harvey, ice cream, Petey and other things Bob knows can make her happy.

You know your loved one. Use things that make them happy. Do it 40-50 times a day if you need to. Hey, it's nicer and gentler than arguing, yelling and generally blowing up.

I did redirect Dotty as a short term fix to the problem of her asking repetitive questions. However, I viewed the Fib, or the redirect as a short term fix only.

What I really wanted to do was discover the underlying emotions and feelings being expressed and work on those unmet needs that resided within Dotty.

I will describe this in the next article on this issue which might be entitled, Why Redirection is Only a Short Term Fix to a Much Bigger Underlying Problem.

Meanwhile Dave here is how I executed my most effective redirects.

I would make good eye contact, smile, and then raise my voice slightly to attract attention and say, Mom, how about we go and get a burger and french fries later?

This would usually lead to a conversation about what the word "later" meant. In other words, how long before we eat.

Like Carol mentioned, I also used potato chips, ice cream, and later in the game the greatest caregiver tool ever invented -- Harvey the Repeat Parrot.

More on this topic coming up soon.

Bob DeMarco is the Founder and Editor of the Alzheimer's Reading Room (ARR). Bob is a recognized influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. The ARR Knowledge Base contains more than 4,000 articles. Bob lives in Delray Beach, FL.
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