Prior to his retirement, my father had worked for many years for a large corporation in a job that he had loved. After he retired, he had increasing difficulty with his short-term memory. One morning while he was visiting me, I came downstairs at 6:30 a.m. to find my father fully dressed, with a brief case in hand, staring out the dining room window at the driveway.

I asked him how he was, and he said that he was okay, but the car service had not arrived, and he was going to be late for his meeting. It was clear that he was both anxious and angry.

Many caregivers face some variation of this challenge. The person you are caring for is convinced that they need to be somewhere else or with someone else. Some women want to pick up children at school. Some people want to see their parents, or a sibling or friend who has passed away. How do you successfully handle these situations?

 

In talking with other family caregivers and professional staff, I have not found anyone with a magic formula. What will work with one person may not work with another. However, there is a general consensus as to the types of approaches that may lead to a smooth resolution.

1. Do not argue or try to correct the person. Telling the person that he or she is wrong typically enflames the situation further. They are often relying on established patterns from their lives; telling them that they are mistaken will often result in increasing insistence on doing that which cannot be done. A person who has always gone to work at 6:30 in the morning may wake feeling the need to get to work. A person who picked children up at school at 3:00 each day may get anxious around that time, thinking that the children are waiting for them.

2. Give them an excuse that will defuse the situation. If they want to go to work, tell them it is the weekend, or a holiday. If they want to pick up their children, tell them that they are having a play date with their best friend who will bring them home later. By understanding what they are reliving, you can try to ease their anxiety.

3. Distract them. After waiting with my father for the “car service” to arrive, I figured out that I might need to drive him somewhere. I told him that I would take him to his meeting, but that we had enough time for breakfast before we went. We had breakfast together, and by then, he no longer was asking about his meeting.

4. Focus on the implicit desire behind the demand. If people ask to see their parents,  assume that they are missing their parent. Instead of telling them that their parent has been dead for 15 years, take their request as an opening to talk about their life with their parent. Ask them what their parent was like. Ask about their looks, how they dressed, what they did together, their favorite things.

 

Sometimes caring for someone with Alzheimer’s requires detective work and experimentation. The more you know about someone’s past – the names of their family members and close friends, their professions, what they enjoyed doing in their free time – the more likely it is that you will understand the impulse behind these impossible requests. If you don’t already know this information, seek out these facts from family and friends.

If you use an excuse that does not ease the patient’s state of mind, take note, and try another approach. Try to see the world from their vantage point and figure out what is triggering the requests.  In working out a resolution, you may be surprised at what you learn about their past lives and how enjoyable the time together can be.