Trying to get DW to Understand Time/Dates/Calendars/Schedules

DaleCosCO

My DW is in early to middle stages of cognitive impairment (not sure what exact diagnosis is yet – evaluation still in progress). She has lost all ability to understand timelines related to dates, schedules and appointments. She often confuses what was a past appointment with what is yet to come in the future. Here’s a current example.

We have camping reservations at the end of June this year, which is now three weeks away. However, she has the understanding in her mind that we need to go today. She’s already packed and insists that all her packed items need to be put into the pickup so that we can make the trip now. I’ve tried explaining to her that we don’t need to go yet, adding that the schedule/calendar will tell us when it is the right time to prepare and pack for the trip. I’ve tried to reassure her that I have the schedule under control and that she doesn’t need to worry or be preoccupied with this.

The above approach isn’t working with her and I’m not sure what to do to explain this and calm her concerns that we need to “leave now!” Any suggestions to help with this loss of understanding of dates/days/times/schedules is welcomed.

ButterflyWings

https://alzconnected.org/discussion/69449/trying-to-get-dw-to-understand-time-dates-calendars-schedules

Welcome though sorry that you need to be here. Please read the excellent article (short book) Understanding the Dementia Experience. She cannot understand and to discuss things like this will only lead to frustration and anxiety, possibly anger for you both. We learn here that it is best to avoid trying to "reason with someone whose reasoner is broken". It is best not to mention "plans" until shortly before it is time to leave. Like only hours.

You will be thinking and planning for two from now on, unless you get a diagnosis that she has some treatable reason for her condition. It is possible, but not nearly as common as those of us whose spouses continue to progress in the downward spiral of one of the dementias. You will have to adjust as she cannot.

There is a story in the Ghent-Fuller article that explains what is happening with her memory, judgment and executive function. It describes a man that reported earlier and earlier to work — e.g. maybe 3am, so he would not be late for 8am start time (I don't recall the details exactly, but you get the point). No amount of reminding or teaching a dying brain will work I am very sorry to say. Here is the link. I hope you will keep posting as we learn from each other. This forum is the best resource there is. Click the link below. It is free.

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

ButterflyWings

Also, we learn to use fiblets, by entering their reality to give a harmless solution to calm their confused thinking. The saying on these boards is "the best answer is the one that gives the most comfort". I am sleep deprived right now, caring for my DH who is late stages (Stage 7) and may have paraphrased that, lol. But I definitely have followed that wisdom many times to keep the dementia loop from wreaking havoc at home.

I don't know if this will work but maybe you can convince her that 'they changed our reservation date". So we will go a little bit later. Then distract her (sometimes a treat or favorite dessert works — and discuss something else.)

Sometimes, too - out of sight is out of mind. Especially as you say she is mid-stages. By Stage 4 DH was still very sharp but I was stunned by the things he did and thought (when he said them out loud), as well as the tales I was able to redirect him with that I thought for sure would not work. The goal is to stop the loop so you may have to disappear everything she has packed. Could you go ahead and load the truck? And then tell her, yep, we leave tomorrow. Then tomorrow you rinse and repeat. Short answer, then change the subject. You can do it!

Joe C.

I remember this phase very well and I agree completely with BW’s post. Trying to reason with a person with dementia is a fool’s errand.

M1

Welcome to the forum, and I have to agree with the above. I would suspect your DW is in at least middle stages by what you're describing. If you look under Quick Links and Groups in the list to the right of the page, there is a group for new members that includes a lot of frequently referenced information, including the Tam Cummings staging tool, which may help you assess where she is.

II hope your camping trip goes well. Be prepared for unexpected challenges though, as sadly you can't assume that her capabilities are what they used to be. That is part of the heartbreak of this disease.

harshedbuzz

@DaleCosCO

Hi and welcome. I am sorry for your need to be here but happy you found this place.

Your wife is no longer oriented to time. Sadly, I suspect that she is further progressed in this area than "early-middle"; PWD can straddle stages, so she could be functioning at a less impaired level with other skills.

I would assume your wife is beyond being able to be retaught how to understand these abstract concepts and that attempts to will just increase her anxiety level around these preparations.

She can't change here; you will need to. It sounds like discussion of the trip and preparations are a trigger for this behavior. I can appreciate it's difficult in a partner-marriage to let go of the notion of sharing everything including the planning and enjoyment of anticipation ahead of a vacation or holiday, but this is clearly a trigger for her. Best practices going forward would be to make all plans discretely and without alerting or engaging her. If you are the sort of planner who relies on visual organizers— lists, calendars, and such— keep these out of her sightline. I would plan on telling her of the trip no more than a day or two before assuming it's something she wants to do.

HB

harshedbuzz

https://alzconnected.org/discussion/65993/excellent-handout-packet-dementia-stages-cgs-actively-dying-tam-cummings

This chart offers insight into which behaviors a caregiver might see in each stage of dementia.

HB

JDancer

For upcoming events, I will often leave a note on the counter. For example, " Angela will visit for 3 days, 6/17- 6/20." And then I don't talk about it until the day before. I'm not sure how much of the information he processes, but he does read the notes several times each day.

SDianeL

My DH lost the ability to understand days, dates, times a year ago. I tried everything. Nothing worked. If you haven't done so already, please get the book "The 36 Hour Day" - it helped me so much early on. Explains the disease, symptoms, stages, and tips on how to be a caregiver to someone who can't reason. A nurse recommended the book to me. Once my DH lost the ability to understand days, dates & times he lost the ability to watch Cable TV. He would find a program that was coming on later and get agitated because he couldn't watch it right then. He also lost the ability to use a cell phone. Sorry you're here for the reason your DW has this terrible disease, but this is the place to find help & support.

DaleCosCO

Thank you to everyone who provided helpful information, suggestions and comments. I appreciate the time you all took to provide me with very useful input.

As some of you mentioned, I am sad to be here, but so thankful that I found this welcoming and supportive community.

Today, I wrote out a "Plan of the Day" and we reviewed it first thing this morning. That has seemed to help her get through the day in steps. Based on this positive response, I will keep trying this to help my DW each day. I am also incorporating many of your comments into my behavior and my responses to her.

Thanks again for the help!

jsps139_

I can NEVER tell my DH about any plans until the morning of, or he worries excessively about it. He has bloodwork due tomorrow, and I won’t tell him until he wakes up tomorrow. This has been the case for many years - his anxiety is off the charts if he knows something is coming up other than our regular, safe, daily routines. I’ll wake him and say, “Oh, I just noticed on my phone calendar that you have a Dr’s appointment. Get you shower so we’re not late, ok.” It works every time.
We just have to learn what works best for them.

l7pla1w2

I think DW is well into Stage 5. She has lost the ability to understand date and time. She can't do the mental arithmetic to say October is four months after June. She thinks 5/02 is two minutes after 5, not a date, especially if verbalized as "five two". She has trouble reading an analog watch.

DW is very conscientious about appointments and wants to be punctual. DW keeps track of her life on a month-at-a-time calendar (which people here have advised I make disappear). She notes appointments, concerts, etc. in it. She goes back through it endlessly and recounts what she did in January, February, etc. But she doesn't remember whether she did those things, so she asks, "Did I...?". She asks about things in the future and asks whether she's done them. If she didn't write something in the calendar, she thinks she could not possibly have done it. She reviews her calendar so much, I can recite what she's done and what she's going to do without looking at it.

Needless to say, the calendar is a prime trigger for looping. On the one hand it's very annoying to me, and her voice becomes a background drone. On the other hand, it keeps her occupied and gives her a (false) sense of being in control. Sometimes I do move the calendar out of sight.

cavenson

For the past few years, I've kept a large dry erase calendar whiteboard on the wall next to our breakfast table. I color code appointments and places we go—blue for him, pink for me, and black for both of us together. I can also put a colored magnet over the current day. The neurologist still considers DH to be ES. Eventually, the calendar may not be so useful, but it's working well for now.

Above all though, trying to abide by the 10 Absolutes in Dementia Care shared above plus a hefty dose of patience make life more peaceful for DH and me.

trottingalong

https://alzconnected.org/discussion/comment/211834#Comment_211834

I am finding this is what works best for me as well, especially pertaining to doctor appointments. Dates and times escape him, but for some reason, some stick in his mind and he gets hyper focused on it and upset.

Bill_2001

Hi DaleCosCO,

Sadly, this is part of the progression of dementia. Time is an abstract concept, which basically means you cannot see it or touch it. The same is true for money/finances. These fall under the larger umbrella of "loss of executive functionality." It is indeed painful to watch these abilities seem to fall away one by one. Each time, it is a shock. You will be more prepared simply realizing that executive skills comprise many tasks we take for granted each day.

You are in charge of the calendar and money now. There are steps you can take to help your loved one keep up with these concepts, but please realize that loss of abstractions is inevitable.

I used a calendar with X's through dates that have passed, a marker board with the day and date on it, and several electronic reminders. These helped for a while, but at some point during my dear wife's journey through Stage 3 (7 Stage model), these concepts become less comprehendible to her.

Take over the calendar. You can explain dates and times to your loved one, but ultimately, the calendar is yours to manage now.

Love, Bill_2001