It is recommended that a person with dementia be told of their diagnosis. However, a person has a right not to know their diagnosis if that is their clear and informed preference.
However, the truth is not always the answer for those with dementia. Lying to dementia patients can be the right way to care for them because: They don't remember the truth and repeatedly telling them or insisting on facts will only cause them distress and pain, especially when it comes to something emotional.
I'm going to discuss five of the most basic ones here: 1) Don't tell them they are wrong about something, 2) Don't argue with them, 3) Don't ask if they remember something, 4) Don't remind them that their spouse, parent or other loved one is dead, and 5) Don't bring up topics that may upset them.
Most experts say that if the affected person asks you what's wrong with them, you should be honest. Knowing that the problem is a disease, not "insanity," is often a relief for the person affected. Telling someone who has not asked may be helpful, particularly if the person appears troubled about his or her condition.
However, telling the person the truth may lead to avoidable distress and they could be unable to understand or remember the information. If the person is in the early stages of dementia, it is usually a good idea to tell them about the death initially and see how they react to the news.
Alzheimer's disease progressively destroys brain cells over time, so during the early stages of dementia, many do recognize something is wrong, but not everyone is aware. They may know they are supposed to recognize you, but they can't.
When someone may be entering the last days of life, a healthcare professional should tell the patient that they're dying (unless they don't want to know).
Administration: The examiner reads a list of 5 words at a rate of one per second, giving the following instructions: “This is a memory test. I am going to read a list of words that you will have to remember now and later on. Listen carefully. When I am through, tell me as many words as you can remember.
In stage 6 of dementia, a person may start forgetting the names of close loved ones and have little memory of recent events.
Stay calm: Focus on preventing frustration and arguments
People with dementia are unaware that they are repeating themselves, so it is not helpful to say to them, “you already told me that.”
Over time, the disease causing the dementia spreads to other parts of the brain. This leads to more symptoms because more of the brain is unable to work properly. At the same time, already-damaged areas of the brain become even more affected, causing symptoms the person already has to get worse.
Providing the person doesn't appear to be uncomfortable or distressed, then sleeping more during the day isn't normally a reason to be worried. However, if a person is lying down in bed and asleep for most of the time they will need to be looked after to make sure they don't develop any physical health problems.
As long as the scenario isn't going to be unsafe or improper, it is perfectly fine to play along with the senior's alternate reality. Doing so won't make the dementia worse. Keep in mind, the senior's reality is true to him/her and playing along can make your loved one feel more comfortable.
Lying, or untruths, may occur at any stage of dementia, but this symptom generally is more common among seniors with mid- to late-stage dementia and can worsen as the disease progresses.
Someone with Alzheimer's disease may start rummaging or searching through cabinets, drawers, closets, the refrigerator, and other places where things are stored. He or she also may hide items around the house. This behavior can be annoying or even dangerous for the caregiver or family members.
Use short, simple sentences and clear language. If the person with dementia is asking about the person who has since died, this can be an opening to then share the bad news with them. This can provide a more natural flow and can help the person who has dementia to process the information.
Often when a person with dementia asks to go home it refers to the sense of 'home' rather than home itself. 'Home' may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.
In the middle stage of dementia, symptoms become more noticeable and the person will need more support in managing daily life. This stage of dementia is often the longest. On average it lasts about two to four years.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
The clock-drawing test is a quick way to screen for early dementia, including Alzheimer's disease. It involves drawing a clock on a piece of paper with numbers, clock hands, and a specific time. The inability to do so is a strong indication of mental decline.
You have trouble following a conversation. You find it hard to make decisions, finish a task or follow instructions. You start to have trouble finding your way around places you know well. You begin to have poor judgment.
Visions and Hallucinations
Visual or auditory hallucinations are often part of the dying experience. The appearance of family members or loved ones who have died is common. These visions are considered normal. The dying may turn their focus to “another world” and talk to people or see things that others do not see.
When you do want to convey a message to your loved one speak softly and use words that help him with his inner work of letting go. You can remind him that you love him, that he has lived a good life, you will remember him, and it's okay for him to let go when he is ready.