歪歪漫画

Dear Carol: Though my husband was diagnosed with dementia four years ago, he鈥檚 had symptoms for much longer. I鈥檝e learned a lot from reading your column and joining a support group, but I鈥檓 still struggling with some of his behavior.

What鈥檚 going on is that he sees and/or talks with his long-deceased parents. I鈥檝e told him that they are waiting for him in heaven, but that upsets him because then he thinks they just died. When I tell him that this happened long ago, he argues and gets agitated. Sometimes I even wonder if this behavior means that my husband鈥檚 not long for this world. I鈥檓 torn between just leaving him alone when he does this and trying to correct his perception. What is the best approach? 鈥� EK.

Dear EK: This is common behavior for someone with advanced dementia, but it鈥檚 one of the many situations where caregivers can feel helpless. We don鈥檛 want to see a person whom we love distressed, and we view the idea that they are seeing their deceased parents as distressing. Sometimes, though, they find it comforting, so read on.

For most people with dementia, short-term memory loss happens significantly earlier than long-term memory loss. This means that your husband is cognitively living at a time when he was younger, and his parents were alive. At least for the moment, this is his reality, so even your well-intentioned efforts upset him since 鈥渉eaven鈥� means that his parents died. As you鈥檝e seen, he then experiences their deaths as if this is new information.

Ask yourself if your husband seems content or upset during these conversations. If he鈥檚 content, then maybe it鈥檚 all right to just let him enjoy this time. Or you could simply say, 鈥淲ere you talking with your mom? I鈥檒l bet she鈥檚 happy. Let鈥檚 let her do what she鈥檚 doing, and we鈥檒l go for a walk.鈥�

If he鈥檚 worried about his parents or wondering where they are, try to validate his concern with some thoughtful expressions of understanding. You could say, 鈥淚 can see that you鈥檙e worried about your mom. She鈥檚 busy right now, but you鈥檒l see her later.鈥� Then suggest a snack or something he鈥檇 enjoy.

The idea is to provide support without having him repeatedly relive their deaths. Some caregivers feel that they are lying when they do this, but in my view, you are simply recognizing his truth.

If you find that he frequently becomes distressed during these episodes, the doctor could prescribe a medication to help relieve his anxiety.

To address your thoughts about your husband being near death himself, that鈥檚 a valid thought. If he were otherwise exhibiting end-of-life physical signs, he might be comforted by the idea of joining them, so that鈥檚 possible. However, from what you described, this sounds more like a memory issue.

My heart is with you, EK. It鈥檚 hard enough when someone in this stage of dementia is a parent. It鈥檚 got to be even harder when it鈥檚 your spouse. Take care.