Sep 19, 2018

Coping with Mirror Anxiety in Dementia Patients

People with dementia move backwards in time, and may no longer recognize their current selves in mirrors (or any reflective surfaces, like inside windows at night-time).

Reflection in the Mirror
by Rita Jablonski
Alzheimer's Reading Room

Some people “friend” themselves (see When Alzheimer's Patients Friend Themselves). They happily talk to and interact with their reflection. Other people become upset when they see a stranger staring at them in the mirror.

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Reflections can cause paranoia or accusations of infidelity arise.
  • Has your loved one ever accused you of having an affair?
  • Or, told you there is someone else in the house?

Think about it. If I don’t recognize my reflection and see some strange person staring back at me, and then I notice my spouse standing next to this strange person, I am going to decide that my spouse is running around with this stranger.

This actually happens with dementia patients.

When mirror anxiety happens, I suggest removing the mirrors. If that is not feasible, place a towel or cloth over the mirror. Keep window shades and curtains drawn at night so that the person with dementia does not see their reflection in the glass.

Some people have decorative art that incorporates mirrors or reflective surfaces. You may need to remove these objects. You can leave the wall bare or replace with a canvas painting/reproduction of flowers or landscapes. Avoid replacing with another picture or artwork with a glass surface.

The next time you hear the person with dementia tell you about a strange man or woman visiting them, or they claim someone is in the house, before you assume that the person is having hallucinations, check around the house for reflective surfaces.

Highly polished furniture, like coffee tables or desks, can be a problem. Table cloths, doilies, even place mats can interrupt the surface and may help with the issue.

Note from Bob DeMarco.

Reflections from mirrors or windows can be a "real" problem for Alzheimer's caregivers. I had the problem that Rita alludes to above. My mother would all of a sudden become disconcerted at night and ask me (demand actually) that I close the shade that we have on a very large window in the back of our home, and adjacent to our living room. She would say, someone is looking in here, I don't want to get rap**. I don't want to even type the word.

Now it is next to impossible for someone to look in our back window, so I thought what she was saying was ridiculous. Then one night I noticed that as she came into the living room her reflection bounced off the window - real quick. Dotty would demand that I close the shade, so no one could look in.. It was then that I realized that she was seeing her own shadow; and that, it was scaring her.

This is but one example of how you have to dig into the reality of your loved one living with dementia. You and I can easily figure out that it is our own shadow. But, a person living with dementia might not be able to figure or reason this out.

As I thought about this episode I also came to the conclusion that my mother had more awareness than I thought. She actually saw the shadow. I started to understand that she was more aware of her surroundings than I thought. So even though her interpretation of what she "saw" seemed ridiculous, she was in fact aware of the reflection.

You should give this some thought while caring. Sometimes what persons living with dementia do and think are a direct reflection of their own perception (reality). You might be able to solve an ongoing problem by being aware of the their perception - even though it is very different than your perception.

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Rita Jablonski, PhD CRNP is an internationally recognized expert in dementia behaviors. She is tenured professor at the University of Alabama at Birmingham and a funded researcher, with over 50 publications and book chapters to her credit. Rita blogs at  Make Dementia Your B*tch. She offers caregivers coaching and guidance for caregivers at DementiaCentric Solutions.

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Author Rita Jablonski
Alzheimer's Reading Room
"Coping with Mirror Anxiety in Dementia Patients"

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