Thursday, July 17, 2008

Looking Beyond Surface Behaviors

There is an ongoing difficulty in interacting with a loved one whose capabilities have been diminished by dementia. I've addressed this problem in my previous entry to this blog; Mom is not where she once was, and I continue to look for her where she was and not where she now is!

Behaviors that would be labeled lazy or even dishonest in the general population must be viewed as being symptoms of the disease process.

For example, if I respond to Mom's reluctance to get out of her chair as though she were being lazy, I am judging her based upon behaviors that are symptomatic, not causal. If I look beneath the surface behaviors I find that confusion, uncertainty, and the inability to logic and reason are behind her need to stay in a place that is familiar and comfortable. She can still reach for the Kleenex box or the cold drink on her chair side table, she can adjust the TV volume control with her remote; in this small world she knows how to function.

Another behavior that caused me at first to either correct or chastise Mom is her tendency to fill in gaps in her memory with creative explanations based on the long term memories that are still intact. For example, if her mini-blinds are clean, she reasons that she's the one who must have dusted them, and she recently told her granddaughter that she just uses a damp cloth and runs it over the blinds once a week or so. To a caregiver, a story like this is offensive on a couple of levels, the first being that I'M the one who dusts the darned mini-blinds and would like to have credit given where credit is due! The second is an upset over the fact that this woman who was the most honest person imaginable, is now apparently making things up.

Mom is making sense of her world the best she can. It is my job to keep quiet and to allow her the dignity of creating order out of the increasing number of confusing facts by which she finds herself surrounded.

Once again, Mom's doing a good job with the circumstances in which she finds herself. And, once again it's the caregiver is the one who needs an attitude adjustment.

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