November 2000

 

Coping With Confusion and Memory Loss
Beverly Pfeiffer, pfeifferb@missouri.edu

If your mother remembers going to a movie but forgets the title, that’s probably just a lapse of normal aging. If she doesn’t remember going to the movie at all, it’s a more serious concern. When forgetfulness and confusion become a problem, you will need to learn all you can about what’s going on with your relative.

Specialists in diagnosing people with memory loss and confusion include geriatricians, neurologists and psychiatrists. For a holistic assessment, seek out a physician who works with a team in a senior health care setting.

It’s important to understand why your parent forgets, because some kinds of confusion can be reversed such as that caused by depression or by medications. On the other hand, Alzheimer’s disease and multi-infarct or small stroke dementia are irreversible.

Once the reversible causes of confusion and forgetfulness are eliminated, and you become aware that your relative’s condition will worsen, you will need to take action.

Approaches that work with confused people.

If an older relative suffers from confusion, plan activities that will keep her happy and busy for the moment. Try to:

• Make directions to the point and one at a time. For example, instead of saying "Hurry up and get ready," say "Come with me. Here’s your coat."
• Ask questions that can be answered with a yes or no. Instead of "Tell me about your day," ask, "Did you have a good day?"
• Remove background noise. Playing the TV or radio while you’re giving instructions increases the likelihood that you will not be understood. Listen to the radio or watch TV when you can relax together.
• Avoid negatives. Minimize chances of getting into situations where inappropriate behavior is likely to occur. Protect your relative from events or circumstances that might cause him or her to become agitated or combative.
• Preserve the dignity of an older relative. Is it really necessary to move your parent if she sits in your seat at dinner, for example? Let her stay where she is and you sit somewhere else.
• Validate your relative’s feelings when he says things that are not based in reality. If your father suddenly asks about your mother, you don’t have to remind him that she died five years ago. Reassure him that she’s okay and then go on to reminisce together about her. What he’s really looking for may simply be the warm feelings he associates with your mother.
• Pay attention to body language. Don’t force your mother to sit down when she appears to need to move around. Assume that her body language (walking, pacing or other anxious behavior) is a sign. She may be cold, hungry or need to go to the bathroom.
• Recognize word substitutions. For example, rather than correct your father who is referring to you as his mother instead of his daughter, give him reassurance that you are someone who truly cares about him. Your smile and touch will tell him that you and he have a special relationship, even though he may not be able to totally sort out what that relationship is anymore.

Source: Adapted from Work & Family Life, 2/00.

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