Sep 3, 2017

Alzheimer's Dementia Patients Have Wonderful Imaginations

I don't think it is well understood that persons living with Alzheimer's have wonderful imaginations. If they tell stories they have an imagination, don't they?

I don't think it is well understood that persons living with Alzheimer's have wonderful imaginations.

By Bob DeMarco
Alzheimer's Reading Room

Did your loved one living with dementia ever tell you a story that was less than true?

I wrote a previous article around this issue that might be of interest to you,

Dementia, Accusations, and Fractured Fairy Tales

I don't think it is well understood that persons living with Alzheimer's have wonderful imaginations. I mean if they tell stories true or not, don't they have an imagination?

My mother was always telling stories loosely based on fact(s).

For example, for at least four years she told this one. She told everyone who would listen that my brother had come to see us from Philadelphia for Christmas. But, he didn't like what he saw, or variation, Bobby said something he didn't like, and he went back home.

Everyone that my mother told this story too - believed it. And, they wanted me to explain what happened.

Now, how believable is a story that would have meant my brother flew 1200 miles from Philadelphia to Delray Beach, got himself into a tizzy, and turned right around and went back home?

The factual basis of this story? My brother called and talked to my mother on the phone on Christmas day.

What did my mother remember? She talked to my brother. She couldn't remember that is was on the phone, so he must have been their in person.

The first 50 times my mother told this story it incensed and hurt me. Keep in mind, I am the antagonist in this story. What did I do, I got angry and immediately corrected her.

However, along the rode in my caregiver journey I started thinking about her wild and wacky tales.

It soon dawned on me that the stories were often based on one or two facts, and then she made the rest up to turn it into a story. I started referring to them as Fractured Fairy tales.

These stories seemed to be coming from different memory parts of her brain, or what seemed to me to be like her fractured brain.

One time, she weaved together a fascinating story for a young person she had never met before.

At the age of 92, she told him she had never taken a medication for anything in her life. Never. Not true of course. She took Aricept and Namenda to name two of six.

She told the young man,

"I am a healthy old broad." 

I might add she was quite proud of this.

We happened to be at the Banana Boat at the time when this story took place.

Dotty then went on to tell him she worked at the Banana Boat for ten years (not true), she did the book keeping (this was true, only the job was at Boca West).

She just went on about the job and people, etc (more Boca West). Meanwhile, the young man is smiling, and raving about the story. He was really having a good time, and so was Dotty.  She was just going and going.

I just stood there watching and listening and to be honest, I was fascinated and happy as a lark at Willow Grove Park.

To be perfectly honest, in the beginning I would have cut her off near the start of the story, corrected her, and told the listener it was not true.

Article - How the Smile is a Powerful Communication Tool in Dementia Care

But over time, I learned these Fractured Fairy tales were really really good, and most importantly,

Dotty was using her brain.

It was often fun identifying the components of the story that were true, and the parts that were made up (or sometimes true, but used out of context).

Dotty always had new and different stories if she met a new person. She also had a bunch of recurring stories that were anywhere from me getting me ready to pull my hair out, to really really funny.

I had to hear for 4 years about how she had hired a lawyer to get her license back, or how she found out who had her license taking away, or how she got her license back and she was going to start driving again.

Topic - Care of Dementia Patients at Home

It took a long time for me to stop pulling my hair out on the driving and license stories, which probably explains why I have less hair now then I did ten years ago.

The stories about getting her yellow Volkswagen Beetle fixed were pretty good.

Of course, no one had seen the yellow VW for 25 years. It no longer existed.

She never actually told me this story directly. She mostly told it to Joanne and Ruth. I learned to laugh and smile at this one.

Hey, at least she remembered her 1976 Beetle. In fact, every time she saw a modern day Beetle on the road she said she was going to get one, or that was her favorite car. Fractured Fairy tale explained.

I admit persons living with dementia often make up stories that put us the caregivers in a very bad light. 

And yes, just like everyone else, for a time, these stories made me angry. But then, I came up with a solution that worked for both of us, Dotty and me. I just started putting my arm around her, gave her the head hug, said something nice and positive, and puff the dark clouds blew away.

Dotty and I both ended up happy and smiling almost every single time.

You do get to choose you know.

You can try and explain to a person living with dementia why what they are saying is not true. Of course, this only confuses the person living with dementia and makes things worse.

You end up having a bad hair day, and they end helping you have the bad hair day.

How does your heart and stomach feel right after you try and explain something to person living with dementia?

So choose. Keep trying to change Alzheimer's World into some other place; or, use the head hug.

Start listening to these Fractured Fairy tales more closely. Soon you will get the hang of recognizing the real basis of the story. Sometimes a person living with dementia needs something but they don't know how to tell you.

Or better yet, they let you know what is still sticking around in their brain. What they like, or would like, or need.

Try to get in the habit of letting those dementia imaginations run wild.

Wanna know what happens next?

They might start telling you stories from the past that are true. Maybe even true stories that you never heard before. It happened to me many times.

Okay, let me ask you.

True or False, persons living with dementia have wonderful imaginations?

Must be something going on in there, don't cha think?

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Original content the Alzheimer's Reading Room