It can be upsetting and frustrating when a loved one with dementia forgets who his/her family members are. Sometimes it’s a case of not being able to recognize faces. Many times I have heard family members say, “He thinks I am his sister,” or “Mom thinks I am her brother.” It can cause distress because it is another reminder that the relationship they once had is eroding away. It is another sign they are losing the mother/father/spouse/grandparent they once knew.
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Get into their world.
One way to look at it is to try to get into the world of the person with dementia. What period of life is s/he in? Is he young and still working? Maybe she is still living in her own home with four young children. When she looks at you, she doesn’t see her 48-year-old daughter. She sees someone she recognizes, but you are “out of context.” It is like seeing into the future. From her perspective, her nine-year-old daughter is in the other room or at school, and this 48-year-old version of her is standing in front of her. She sees a familiar person, but is not sure who.
Put yourself into context.
Consider this – How many times have you gone to the supermarket or to another public place and bumped into someone you recognize. You make eye contact, but you can’t figure out how you know this person. He is familiar to you. He smiles and says, “Hello!” and addresses you by name. He asks how you are doing. You still can’t figure out who this man is. You smile back, but stay silent because you don’t want to appear silly. Finally, he says, “I am Bill, we met at the last staff meeting. I am the new guy,” as he chuckles. You are relieved because now you can place him. He was out of context. You didn’t expect to see someone from work at the supermarket. When he explained how you knew each other, it helped place him into context.
Clarify if that’s what is needed.
That is my take on how to understand and respond to someone with dementia and/or memory problems. S/he may need a little reminder of who you are and how you fit into her/his life. Putting everything into context can help relieve the person’s anxieties and insecurities. Even if she thinks you’re her sister, that’s okay, too. If she asks for clarification or she is not sure who you are, gently remind her and put yourself into “context.” S/he will most likely respond favourably.
Avoid using a disapproving tone.
It’s a natural reaction to want to be angry or disappointed with the person. At times you may have responded in a disapproving tone and said something like, “I’m not your sister! I’m your wife.” This can result in making your husband feel more confused and ashamed.
Respond in a calm and reassuring manner.
The next time your loved one with dementia mixes you up with another family member or is not sure who you are, consider responding with kindness, patience and understanding. Help put yourself into context. That may help her/him remember who you are.
NOTE: The medical term for the inability to process sensory information is called agnosia. There are different forms, including prosopagnosia, the inability to recognize faces. Check out Wikipedia if you want to learn more about agnosia, or watch this video on YouTube called Prosopagnosia.
Angela G. Gentile, M.S.W., R.S.W. is a Specialist in Aging who has more than 25 years of experience working with older adults and their families in a variety of capacities. She has worked in private practice, long-term care, home care, health care and non-profit organizations. She is a realistic optimist who lives in Winnipeg, Manitoba with her husband and two children.