COMMUNICATION GONE HAYWIRE

The brain of a person with dementia loses information and words, and their connections to both become haywire. This can create recurring obsessional behavior or give rise to repetitive delusional beliefs. Both are commonly a need to communicate something.

One woman was obsessed with wanting to know about Princess Diana’s death. She drove her daughter crazy with repeated questions about how she died, when, and why. Subconsciously she was afraid of death and dying, and her daughter should talk to her about her feelings about Princess Diana’s death. This would enable her to release her tension about death and her own death even if she only discusses Diana.

One needs to look beneath the surface and try to understand what the person is attempting to communicate. They usually aren’t aware of this, but their actions or words are generally indicators of a personal unaddressed issue, fear, or need. With dementia, delusional thinking is commonly connected to an unaddressed need or fear that manifests with repeated behavior, and it’s essential to try to interpret what’s really going on.

Wanting to go home is another example. “I want to go home” isn’t usually a physical place; it’s an emotional one. Home suggests safety, familiarity, comfort, and love. You hear this commonly in eldercare facilities where they don’t feel at home.

Another is delusional beliefs the other person is trying to control them. Again, they don’t feel safe, and they are struggling with a lack of control in their own lives. Commonly they become combative, insisting they are right and sometimes accuse their caregivers of plotting against them. This is a need to regain control.

A friend of mine was in the last stages of cancer, and she had developed dementia. She fought with everyone to go to the store because she needed shoes. She was bedbound at the time and would struggle with the caregivers trying to get out of bed. Shoes meant she wanted to walk again and leave. A week before she died, she stopped demanding to shop for shoes and began saying, “I gotta get outta this place” over and over. Shoes were connected to that communication.

I was caring for Betty on the night shift. She repeatedly said a man was trying to get in the window. She didn’t feel safe at night. Each night I pointed to a parked car and told her it was an unmarked police car, and the police were there every night to protect her. She had the delusion a couple nights more and then slept like a baby.

I was helping feed my friend, Frank, who was in later dementia. He was losing weight steadily and was gaunt and thin as a rail. With the food sitting in his mouth, he said over and over, “Can’t. Can’t”. When I mentioned this to the staff, they replied, “Oh, he always says that.” Furiously, I replied, “He says this because he can’t!!” I talked to his doctor, he was put on pureed foods and gained 10 pounds in a week.

If the person with dementia constantly repeats the same thing or same behavior, it could be an unmet need being expressed through a haywire communication. Try to find the underlying reason and address it if possible.

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