Each time I work with a family of a patient with dementia, I witness another unique situation and way of handling challenges. I was recently thrown a curve ball and am not proud of the way my gut told me to advise a family member. However, the situation prompted me to delve deeper in my contemplations of this subject and thus I’ve allowed it to help me grow as a clinician.
I have a client who is very sick in the hospital and may never return home. Her husband has dementia and lives at their home. Recently, her son asked me what to say to his father who asks repeatedly when she’ll be coming home. My mind flashed to the image of a confused man in a memory care unit desperately asking everyone who walks by him to help him find his (late) wife – something I observed once in my work. Immediately, the thought popped into my head to advise my client’s son to tell his father, “she’ll be back tomorrow,” as a way for his father to avoid receiving upsetting news over and over again.
I first advised my client’s son to keep his communication simple and straight-forward. As I heard more from him about how my client’s husband has been coping, I learned that he does not remember the answers he is given about his wife. While acknowledging the complexities of the situation as well as my complete unfamiliarity with my client’s husband, I went ahead and offered my idea, the overly simplistic and dishonest answer of, “she’ll be back later.”
My client’s son went on to share with me that thus far, he has been telling his father, “not soon, possibly never” in response to his question of when will his wife come back. He shared with me that his father seems to understand and accept this news in the moment. Through discussion, we both agreed that the way he had been handling this communication with his father has been an honest, compassionate, consistent, and very appropriate approach.
I am impressed by the way this man so thoughtfully considers his communication with his father. The issue of communicating difficult news to someone with dementia certainly does not have a “one-size-fits-all” solution. There are many factors complicating each individual’s situation, including the stage of their dementia, their individual personality, and their relationship with the difficult event or person. My admiration is high for caregivers and family members who so sensitively and thoughtfully handle these challenges.
Below are a few helpful resources/articles I found on this topic.
https://www.pathwayshealth.org/dementia-care/dementia-patients-and-grief/
http://www.alzscot.org/assets/0000/0176/loss_bereavement.pdf
http://www.healthcentral.com/alzheimers/c/62/105038/dementia-loved/