Dementia Care

Instead it encourages family members, who may well not understand the differences, to think of their Mom or Dad or Grandpa as being mentally ill. Given the huge amount of prejudice against the mentally ill in our society, we really don’t want to bring that into the way we look at elders with dementia.

I blame Hollywood for part of this. Using the word dementia and demented to describe people wayyyyy out of control has only tended to confuse everyone even more.

Five Words Not To Use About Dementia:

1. Paranoia:
People with dementia are not paranoid. They are scared because they are losing their short-term memory and can’t keep track of life. You’d feel just the same;

2. Combative:
They are not violent because of dementia. They hit you when you are an unskillful, invasive, bossy caregiver;

3. Perseveration:
Repeating the same words, phrases or questions over and over. That’s actually not due to anything psychiatric. It’s due to short-term memory issues and long-term emotional needs which possibly are not being addressed;

4. Delusion:
Thinking they are living in a different time zone from this is not properly classified as a delusion when two things are at work — short-term memory fragmentation, combined with memory intensification of long-ago experiences;

5. Hallucination: If it’s dead people coming to visit, sorry but that’s a normal part of old age and dying life. It’s very rude to classify a universal phenomenon found in ever culture as mental illness in one of them. Who’s to say the dead can’t visit? Certainly not a psychiatrist of no faith at all. In hospice work, the visits of the dead to living are recognized as very comforting and not otherwise classified.

Let me just remind you WHY we should not easily allow the language of psychiatry into the world of dementia. Because it tends to nullify communication between the person with dementia and their caregivers.

Caregivers who allow psychiatric jargon to describe the life of a person with dementia lose meaningful relationship with their person. They tend to dismiss any possibility of either admitting there is real meaning to many of the communications. They often resort to psychiatric medications, which are merely chemical restraints and often quite harmful to the person with dementia. There are many reports now from both Britain and Canada, as well as the United States, demonstrating a high death rate among elders with dementia being wrongly medicated with anti-psychotic drugs.

It is not unheard of for an elder to have what is usually referred to as dual-diagnosis conditions. That is, to both have dementia and also to be mentally ill. As an observer, I see that too often mentally ill elders are thrown willy-nilly into the dementia population where they may actually cause a lot of trouble due to their mental illness.

It also encourages inattentive and ignorant caregivers to blame things on dementia which strictly belong to the realms of mental illness. Families of such elders are usually only too happy to have their parent put into a dementia unit because care is better and caregivers more sympathetic than in a geriatric psych unit

However, to actually do that is a form of medical malpractice which puts everyone at risk. It should always be challenged by care staff in dementia or memory care units and can always be reported anonymously to the state licensing authority.