Redirecting conversations over the phone with mom with dementia/Alz

tbranchaw

My mom is in a memory care facility 3 hours away from me. Often, we have very pleasant conversations over the phone. Recently, she has been saying she is trying to call her mom/dad to pick her up and take her home (they have been deceased several decades). When I try to redirect, she will get extremely upset and repeat, "but why did no one tell me?"… this has become a common refrain for all the things she can't remember-(that her parents died, that her husband died, that she moved from her house 10 years ago, that she actually chose her residence, etc). Since I'm not there, it's getting more and more difficult to answer her questions or redirect to another topic. I often text/call the nurse on duty to go check on her and bring her something to help calm her down-which they will always do. Any suggestions for long distance conversations? I find that sometimes I just have to hang up because she gets so upset-I tell her I'm calling my brother to have him come over and help her, which calms her sometimes, but not other times.

Finally, I'm no expert in the progression of dementia/Alz, but is the reverting to ever more early memories common? And is the level one gets upset/confused increased or decreased? I know every person is different, but I was wondering if there is a general pattern.

Emily 123

Very common. The disease is progressing through her brain and affecting how she accesses and processes older information, and it's removed her ability to retain current information. Especially with Alzheimer's, memories are lost on a 'last in/first out' basis as the disease progresses. Outwardly she may still be able to carry on conversations, but it sounds like she's lost some intervening years. For her, there's 'right now' and then there's a gap in her memory (that she can't sense) that goes back a while. She sounds like she's far enough back on her timeline that her parents are still alive, so may even think she's much younger than she is. She doesn't recall their passing, and the news of that, as well as not knowing about their deaths, must be both shocking and painful for her.

Since she doesn't have the capacity to retain the information it's not necessary to tell her of these painful things or try to ground her in the here and now—You can see from her reactions that it will be gentler to meet her in whatever timeline she's on and go along with her reality, even if that means skipping around the truth. There's no harm to her thinking they're alive, and since she's suffered their loss once there's no need for her to do it again.

If you can't divert her, try to come up with a likely reason why they aren't available and then move the conversation along. For instance, if your grandparents took a vacation every year, tell her they're away and will be back later. If she's confused as to why she's in the MC tell her it's for rehab per her doctor, or because the house is getting repaired. Alternatively, if you can't divert her there's no harm in ending the call before she starts to get upset. It will feel odd to talk about family that have passed on this way at first, but—eyes on the prize—you'll have a calm mom.

These may be helpful…

Understanding the Dementia Experience:  

https://www.smashwords.com/books/view/210580

Tam Cummings assessment tools/AD checklist

https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

M1

Hi tbranchaw and welcome to the forum. Unfortunately I think there comes a point at which talking on the phone or even FaceTime is simply not a good or feasible strategy for staying in touch. I'm dealing with that now with my partner and her extended family; she just can't manage phone calls any more and most of the time doesn't know who these people are or why they are calling, doesn't know what to say, and would rather not be on the phone, period. That's likely to be very hard for you, as her daughter, but it's probably reality, and I wish there were some easier way to help you deal with it. As with so many things with dementia, the loss of contact may be harder on you than it is on her. It makes it somewhat easier for me in that my partner has no sense of time whatsoever, and i am pretty sure doesn't miss me when I'm not there or have any sense to the time between our in-person visits. I am sure part of the fear for you is that she may forget who you are entirely. I've had that happen, too, and it is painful. Wish I had something more substantive to offer, but just trying to help you think it through.

Quilting brings calm

I think you need to quit answering her questions about her parents, house, etc. Instead of replying to any topic with an answer you think will upset her- immediately change the subject:

mom- so and so hasn’t been here

You: what activity did you do today? Or What did you eat for lunch? Or did you see how much rain we got today?

If Mom replies- but why haven’t they been here

you: I think they’ve been really busy - I will call them- did you sit next to your friend Mary at lunch today? how is she?

harshedbuzz

@tbranchaw

It is very common for PWD to time-travel to previous periods in their lives as the disease progresses. It makes sense, in dementia memory is LIFO with short-term and recent memory fading earlier than those from their youth and childhood.

Every time you inform your mom of the deaths of those important to her, she is hearing it for the first time. It is cruel to continue to do this. She can't change or recall information, so it's best to join her reality.

My dad talked about my late sister— his favorite— constantly. On the days he was hazy about her having died, I would use his questions about her as a conversational segue and tell him a funny story from her childhood. It kept her "alive" for him and made him happy. Sometimes he'd wonder why she hadn't visited, and I stick to a story from her young adulthood when she was a busy single mom and would probably come over the weekend. We told my aunt my widowed aunt who was mentally living in the married student housing at Rutgers circa 1950 that her husband was on his reserve weekend.

HB

mrsabaldwin

https://alzconnected.org/discussion/comment/209243#Comment_209243

I have definitely come up with reasons why family members are not around. I try to pull from what I remember of the types of things family members would do. I have said everything from Dad is at the store to Grandma and Grandpa went back to Oklahoma to get a car someone is giving them (my grandpa was crazy about cars). All sorts of things. It is just more reasonable for my mother to comprehend and honestly, it is easier on me as well.

I had a entire conversation with my mother the other day where she was asking about one of her sisters who actually passed away in 2018. I realized pretty quickly that mom had traveled pretty far back in time. And I asked her if her sister had ever mentioned wanting to move out of state. That lead me to be able to say that her sister was living in another state and kept mom calm until I was able to move our conversation in a different direction.