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I don't think I know you...

Imagine that you just woke up and a random person you’ve never seen in your life is standing over you, telling you to take some pills you know nothing about and asking you questions in a condescending tone.

Imagine that you look in the mirror and the face looking back at you isn’t your face.

Imagine that there’s an annoying woman, whom you’ve never met, telling you that she’s your daughter, but you have no recollection of this or of even being old enough to have an adult daughter.

Imagine that you find yourself in what appears to be a hotel room with some stranger’s belongings everywhere. You don’t know how you got here or why you’re wearing someone else’s clothes.

Imagine that you are trying to communicate but the words no longer come out the right way.

If you think of yourself in these scenarios, would you feel scared? Would you feel anxious? Would you be adamant that you’re right and everyone else is wrong? These feelings are natural! Perhaps if we start to look inside the natural emotions of someone with cognitive decline due to Alzheimer’s or dementia, we might have a better chance of offering them a little more peace of mind even if it’s temporarily.

If a loved on is in the beginning stages of cognitive decline, you might find that they try to mask, cover up, or find excuses for the shift in behavior. This is very common and some people can get away with it with strangers for years. With loved ones, it might be a little more obvious. Loved ones will often notice a change in behavior, especially when the person suffering is tired, stressed or overwhelmed. Most family will also notice a change in sleeping and eating patterns and a decline in personal hygiene.

The anger, anxiety and fear that comes with dementia is staggering and if we show just a little bit of compassion for our loved ones who are suffering, we might just get a little more out of the time when they are lucid and calm.

~Yes, and!

Dealing with dementia in a loved one is very similar to performing improvisational theater. If you’re not familiar with improvisational theater, it’s a form of performance where the actors make up the story as they go along and play off of each other to do so. One of the hallmarks of improv is “Yes, and”.

In my undergrad theater class, we practiced this by playing a game where we validated the story by saying, “yes, and” after a fellow actor fed us a line. This is much more difficult than you realize, even with a made up game and a classroom full of peers. I give mad props to improv actors because it’s really difficult to continue to validate fiction.

The bottom line is that the version of the story that your loved one with cognitive decline is experiencing is the version that matters, and you can put your ego aside for a while to make your interactions more pleasant. We as caregivers need to validate them. If they are scared, find out why. Instead of telling them they are wrong, validate their feelings and try to steer the conversation to something else.


Mom- “Who are you and why are you in my house?”

Son- “Mom, it’s me, your son. You called me this morning to help you with your television and you just let me in the door before you went to make tea.”

Mom- “I don’t have a son. I have no idea what you’re talking about.”

Son- “Mom, don’t you remember? You called me! I came in and you hugged me and offered to make me some tea. You literally just walked into the kitchen.”

Mom- “Stop calling me mom, my name is Kathy and I don’t have a son. I still don’t know who you are or how you got in here.”

Son- “But mom, it’s me. Look at me! It’s your son!”

Mom- “I think you need to leave or I’m calling the police.”


Mom- “Who are you and what are you doing in my living room?”

Son- “Yes, and I came by to meet you today. My name is Matt, what’s your name?”

Mom- “Hi Matt, I’m Kathy. I have a son named Matt, but I still don’t know how you got in here.”

Son- “I’m sorry, Kathy, the door was unlocked and I was told to come by today because I heard you need a handyman to fix your television.”

Mom- “Oh, yes, I don’t know what’s wrong with it, but it won’t turn on. Come over and take a look.”

Bottom line: Validate and redirect. Sometimes they will come out of their confusion quickly, sometimes it takes a while but the idea is to diffuse the fear and help your loved one relax, even if they don’t know you. Be kind and help them navigate their narrative because they are not being difficult on purpose.

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