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As a rank beginner in the field of
eldercare I was excited to finally be turned loose to make my
first independent home visit. It went well, I thought, until I
returned to the office. At the door I was met by my supervisor.
She informed me that she had just logged an official complaint
from the client I had left not 20 minutes earlier: The client's
teeth were missing. The teeth were there before I arrived, and
they were now missing. The conclusion was obvious.
I was devastated. Later the dentures were found by the client's
daughter, wrapped in a napkin and stuffed in the toe of a
slipper. Everyone had a good laugh, but I'll never forget the
feeling of shock and indignation I felt at being unjustly
accused. Lucky for me it was teeth (who would want those?) and
not an expensive piece of jewelry that went temporarily missing.
People who have Alzheimer's or other dementing illnesses must
struggle with their personal reality that every moment is a new
moment. There is often no memory of the moment that went before.
Things inexplicably disappear when you have no memory of having
moved them. When your things are constantly disappearing, the
"logical" solution is to hide them in a safe place
where no one will find them. And then they are lost again.
When your memory perversely retains the information that
something is scheduled, but you can't remember whether this is
the time or the day, you will ask someone. And ask, and ask,
because you can't remember that you already asked or what the
answer was.
Just try to imagine how frustrating and frightening it must be
to live in this confusing world where things disappear, someone
else is in control of your money, conversations often don't make
sense, or your brain doesn't recognize the home where you've
lived for many years. Is it any wonder that suspicions and
"paranoia" often accompany dementia?
Things That May Help:
Don't Argue - Arguing with a perceived "fact"
may increase agitation and anger, and may lead to a catastrophic
reaction. Instead, acknowledge the feeling: "I know it's
frightening when you can't find your _______. I'll help you look
for it."
Make a List of Favorite Hiding Places - Never throw out
the trash without first checking for hidden items.
Try Distraction - A new activity in a different room may
divert attention from the anxiety of the moment. This rarely
works if emotions have escalated, however.
Keep Spares - If certain items are disappearing time
after time, keep extras on hand to use until you find the
"lost" item. Buy in pairs or even triples if possible.
Try to Keep Caregivers Consistent - New faces may be
targets for suspicion because the explanation of who they are
and why they are there is forgotten.
Avoid Unnecessarily Announcing Appointments or Events -
If your elder worries excessively about missing an appointment,
wait until it's time to get ready to go.
Reduce or Eliminate Clutter - Remove excess items from
closets, cupboards and drawers. "Lost" items stashed in a shoe
are easier to find if there are only two pair to
check.
Remove or Lock Up Valuables - This will protect aides and
family members from suspicion.
Advise Family Members and Home Workers About Typical
Behaviors - Let them know that they may be accused and that
they should not take accusations personally.
Schedule a Medical Check-Up - Rule out other medical and
psychiatric problems or the possible side-effects of medications
already prescribed. In some cases where paranoid behavior is
causing major problems additional drug treatment may be
appropriate.
Listen Carefully - If your elder with dementia has a new
behavior or a new concern, listen. Sometimes things really are
stolen. Sometimes abuse is real.
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