This is what I believe – and I’d like you to respect that


Posted on June 29th, by geoff in CT blog. 4 comments

By Caring Times editor Geoff Hodgson

I have been monitoring (and have contributed to) an online discussion about the pros and cons of ‘encouraging people with dementia to live in the past’. To me it is plain sailing.

When we are children, we often encourage our parents and grandparents to reminisce; “Grandpa, tell us about when you were a boy” etc. We ourselves live in the past for at least some of our waking hours; regretting past mistakes, fondly conjuring memories of past loved ones and wonderful holiday moments.

Of course we who do not have dementia are aware that we are reminiscing and the concern appears to be that people with dementia actually believe that their spouse is still alive and will soon be coming home from work, or whatever – that they do not have this awareness.

My response is so what? We all know people whose beliefs are different from ours; who have a world view dissimilar to our own. Happily, most of us respect other people’s beliefs, whether they be religious, political, food- or fashion-oriented. Why should we not respect the beliefs of someone with dementia?

If someone invites a discussion of one of their particular beliefs then I see nothing wrong with engaging; it might be churlish not to. But the question that challenges some of us is, do you validate someone’s belief as a matter of course, without being directly asked to do so? Do you just go along with them?

Why not? We vicariously share in the memories of our grandparents, why not with a person with dementia? I think there is sometimes an unconscious arrogance on the part of healthcare professionals; an attitude of “I know better than you what is best for your well-being”. That may often be true, but it is trumped by the requirement to accord the people we are looking after the dignity and respect we would accord to anyone else.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.




4 responses to “This is what I believe – and I’d like you to respect that”

  1. Bob Ferguson says:

    “Going along with them” is all very well, but there could be circumstances in which, I’m afraid, you may just have to insist on reality – if only to keep your own sanity. My mother lived with dementia for a few years before she died in my care home. She was given to complaining that her grandson, my son, hadn’t called into her room to visit her, even though she “knew” – in fact, she was convinced – he had been in the building. She “knew” because she had heard me shouting at him. He was actually a few hundred miles away at the times in question. And I told her that, gently, reminding her of the times he had actually visited her. I saw no point then, and still see no point now, in just going along with her belief.

    Worse than that, however, was when she accused me of getting up to hanky-panky with the lady in the adjoining room. You see, she had “heard the bed going”. Should I have gone along with that? Really?

    It’s not quite as simple as it may appear.

  2. John Burton says:

    No, it’s not simple but Geoff is saying that the old “reality orientation” approach (which, we should remember, was once professionally approved) of attempting to correct people’s thought and perception is now so obviously wrong in his view. I agree.
    Of course when we are talking about family, the complexity of relationships and feelings, the influence of the past, and the unconscious topsy-turvy relationship of son caring for mother (I too have experienced that) make the acceptance of blatantly false “accusations” (which all have some sort of “real” connection with current emotions) hard to swallow. It is the emotions behind the accusations that are the important bit.
    All the more reason for “professionals” to be able to understand and accept where someone is coming from and where they are now in their reality, and to attend to the emotional roots of that reality.

  3. Bob Ferguson says:

    Apart from all that blah about accepting and understanding, John, try this on for size. A few weeks before suffering what would prove to be a fatal stroke, I found my late mother – yes, it’s that woman again – distraught by the recollection that she had, in her words, committed adultery while my father was abroad during the war. You can imagine my reaction.

    A little digging revealed that the “adultery” had been restricted to dancing with a male friend of a friend. I know because I was there, clinging on to her skirts, as possessive little boys do, as they foxtrotted around to Victor Sylvester’s strict tempo on the radio.

    I was able to reassure her that her feeling of guilt did not amount to “adultery”. That was the reality. Should I have simply acted “professionally” and gone along with her (mis)interpretation, leaving her to suffer? You must be joking. I’m happy to report that I behaved like a rank, but caring, amateur.

  4. geoff says:

    Bob,

    I fear you are confusing banal family dynamics with at least respecting another individual’s world view. As we seem to be recruiting our mums, mine (who celebrated her 100th birthday yesterday) has refused to see her 13-year-old great granddaughter for more than 18 months because said granddaughter clattered about mum’s house in a pair of high-heels. My mum doesn’t have dementia; she’s just an intolerant old bat and of course we try to reason with her.

    But if I were a carer, looking after my mum who had dementia (and not being related) and she told me that she was upset because her great granddaughter was a prostitute, I think I would accept that this was her belief and offer what emotional support I could, though of course I would enquire what made her hold that belief. So you are right in saying it’s not simple.


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