Dementia Confabulation: When to challenge and when to "go along?"

You say “you can’t fix stupid”. I have one for you that - if you can “embrace” it, will make your life a lot less frustrating: You can’t reason with dementia”. Seriously- you can’t. You’ll never win this battle and the sooner you accept it, the easier your life will become.

So, if people contact you? You laugh gently and say "oh, you DO know that mom has been diagnosed with dementia, don't you? It's really sad that her brain is so broken at this point that she thinks that her loving children are doing bad things."

You don't argue with them; if THEY argue with you, you say "I'm really sorry that you don't understand the nature and extent of mom's disease."

Amber, no you do not have to go along with insults to your face, of course not. But that's different from the kind of confabulation that you clearly understand, with your mother trying to make sense of her memories.

Offensive remarks fall under the heading of challenging behaviours rather than faulty memory. If responding proportionately with something like "that is not a nice thing to say" doesn't help or makes things worse, then there's nothing for it - you'll just have to do the "I'll come back another time" routine and cut the visit short.

Do you ever actually need to spend time with her, or is it always optional?

Countrymouse, this first year has been rough. My sister works full-time and I'm retired, so I've pretty much been "it" for doctor's appointments; however, the good news is that we've pretty much got Mom caught up with doctor's appointments. She is fully managed now by a visiting internist who comes to memory care. The internist refers her as needed, so from now on doctor visits will be few and far between. Sister picks her up sometimes and takes her on outings. I quit taking Mom on "pleasure" jaunts months ago. I wouldn't think of taking her home with me even for a day; I care too much for my own health and sanity to involve myself in situations she utilizes as opportunities for personal attacks.

My expectation is to see Mom once a month, if that, in 2018. My policy when she gets nasty: "I'll be back sometime when you're feeling better," "I need to take you back to memory care because I'm going to visit/do so-and-so," or "The doorbell's ringing, I have to go now."

Rainmom, you're right: reasoning with dementia is hopeless. The only thing I want to do is respond in a way that doesn't support a falsehood about me or those I care about. Call me stubborn, but standing by like a numb-nut while Mom reams my sister ain't an option. For me, silence is tacit approval, even with a demented person. I guess the best thing for me to say is "That's not a nice thing to say, Mom." Please understand, I know I'm the one with the problem here. Mom has always lied, slandered, fabricated, whatever you want to call it, long before dementia set in. I know I can't fix her, dementia or no dementia. I just need to find a satisfactory way to respond to the false assertions for my sake, not hers.

Barb, I probably shouldn't care so much what other people think, but I like your responses! I will have to practice a bit (grin) until I become expert with it!

Thanks to all!

It sounds like your mom has a long history of mental illness, now complicated by dementia. Limit your contact, rehearse your pat responses and find love and support from your partnership with your sister.

I also follow the once a month rule except for major holidays and birthdays. And I also refuse to let things my father says go. He tries to manipulate me and it is extremely obvious and I refuse to play along. We did get into a big fight over it a month ago and I got disowned....until he needed me for something and then totally 'forgot' about it.

lkdrymom,

Your dad and my mom must have gone to the same school!

Mom's memory is very selective. She only remembers the bad stuff. One of my visits with Mom will end poorly, like they usually do. I'll leave, and she won't hear from me for awhile. Then she'll call when she needs something, referring to the unpleasantness of our last get-together but never apologizing for what she knows was nasty behavior on her part, instead assigning blame to me. Then she'll forget and the cycle repeats, over and over and over. I know it's the dementia, but I also know Mom's hard-wired narcissistic ways are worsened by the dementia. So I say the serenity prayer a lot!

AmberA,
My mother and yours sound very similar. Except I am an only child and my mother attacks my very helpful and wonderful wife as well. I realize it is her real, spoiled personality coming out without the social skills to cover it up.
She started being really abusive about two years ago, making up horrible things about me and what a horrible person I am. These stories went from when I was 25 back to 9 years old. Of course the abuse was forgotten once she needed something. Which was most days.
When she fell and had to be in the hospital and rehab for two weeks, I visited daily. My wife helped with her bills, and for convenience we paid many of her expenses ourselves, just as we had with my in-laws and father. She accused my wife of stealing from her when she couldn't remember the reason for some checks.
She was just as needy and demanding when we were taking care of my two in-laws (both became nicer as they aged), a daughter struggling with serious mental issues, and a son with physical problems. A demanding, total narcissist.
One thing that helped me. I gathered up a bunch of receipts and wrote that we paid them for her on each. I included a long letter about how we helped her in spite of her abuse, and gave numerous examples of her outlandish behavior. I also wrote that she was affecting my health (true), and in the future I will just leave if I feel uncomfortable with her behavior. I also said I do not expect her to change, but that I can control how I react to her. I did not talk to her or see her for a week.
The letter seemed to help a lot. I think it was because she could read it over and not fill in the blanks like she does with a remembered conversation.
I have stuck to the walking away strategy, and refuse to engage her when she starts with the negativity about anything or anyone. I do not accept apologies from her for any reason, I tell her she will just do it again and everyone will feel worse the next time.
Her behavior is much better now, we even had her over for a meal, something we have not done in more than a year.
I still will never trust her again, and I still try to minimize the contact, but the relationship is tolerable for now. I still get the occasional call from the senior community staff when she throws a tantrum, but at least I am not the object of her hatred and have been able to minimize my own stress.
It is stressful to worry about other's opinions. The only opinion that matters is yours.

Amber, have I got a book for you! My sister just sent me this book from amazon written by a psychologist who deals with geriatrics and counsels children of parents like ours. Here is the title: Loving Hard-to-Love Parents: A Handbook for Adult Children of Difficult Older Parents by PaulChavetz. It gives you tips and pointers how to deal with this sort of behavior.
My dad too does what you are saying. His reality has gotten much worse since his recent surgery. He’s now accusing my dear sister who has been such a help to him of using the money from his estate sale to go visit Cuba!! The estate sale was 4 yrs. ago but he thinks it was recent.
I have to decide how I will deal with this. I know he doesn’t even know what he’s truly saying as he’s created this alternative reality. And yet if I reason with him it gets ugly. Truly you have to detach even when hurtful things are said. Sometimes he will tell me I’ve changed and that I used to be nice. Especially if I try to say the nurses and staff in rehab can’t come immediately when he calls because they have other patients. He feels I’m taking their side. And silly me, I’m trying to use logic. Logic doesn’t help!! I’m a slow learner sometimes.
So think of it as though you are watching a movie unfold and he’s talking about people you don’t know. And say things like...really?...you don’t say?...and then try to redirect and talk of something you know cheers her up.
But get this book!

When my dad told me about not being a nice person anymore, I began to get ready to leave. But I also told him that I came to bring him a shake and visit him and the first thing is complaints and not that it’s nice to see me. Then he calmed down. I think a slight confrontation is fine as long as it doesn’t get into a screaming match as you won’t win and your blood pressure will go up and your health will be affected in some way. In that case you’ve given your power away and she wins. You are the one who has control over your words and actions. Never forget that.

I agree with enderby's advice. Your mother is still a living being who has to respond to your limits. To "embrace" her bad behavior or turn the other cheek would just reinforce her.

My mother has narcissistic personality disorder, now overlain by dementia. She has always demonized me and cut me out of the family while glorifying my drug addicted, alcoholic brother and sister. I've been all alone, without a single ally, and envy that you have your sister.

I am absolutely amazed by how many narcissistic, abusive parents there are out there. It is so sad! How people can inflict that kind of pain on their children is just incredible.

I, too, have a narcissistic mother. She’s 96, lives in an independent-living senior apartment (no assistance there), can’t afford assisted living and we are currently having conversations about skilled nursing facilities (I hate the term “nursing HOME” ... they are not HOME, they are noisy institutions where we send our elderly after taking everything they have accumulated in life away from them ... but that is a whole different thread! 😳 ) My mother does not watch TV, listen to music, read books or magazines, she just sits there in her recliner by the window in silence all day and watches her neighbors out the window, making up lives and stories that are just completely whacked! A wonderful woman in her 50’s moved in next door, was so kind to give my mother her phone number and say, “If anything ever happens and you can’t reach the phone but you can read the wall that separates us, bang on the wall and I’ll come and help you!” My mother talks incessantly about how this woman wears shorts that are way too short and dresses that are way to tight, has men visit her (who could be brothers, cousins, friends, she has no idea), so she must be a prostitute! She has now convinced herself of this and tells me all about her comings & goings. This is not isolated. She has said horrible things about all of the lovely women there who check on her well-being, have offered help, etc. One is addicted to opioids, another must be gay because she looks it, etc. Sometimes I just want to scream, “these poor people only made the mistake of being kind to you, and you repay their kindness by slandering them!” I can only imagine what she says behind my back, as to my face she has told me that I am a know-it-all and the reason for my divorce 24 years ago was that he couldn’t stand me anymore (in reality, he was an alcoholic and I divorced him), that my wonderful husband Bob will not put up with me for long and he’ll kick me to the curb, and that the whole problem with me is that she was not hard enough on me when I was little! It has taken me a long time, and a fair amount of counseling, to learn to calmly respond that I’m not going to stay and be abused so I am going home and will call the next day to which she’ll respond with something like, “If I don’t die before then.” I have driven almost an hour down there stayed for 30 minutes to make sure her dishes are washed, bed is made, garbage is tossed, sh*t is cleaned off her toilet seat, and she has food, turned around and driven home. Anyway, it’s hard to hear the confabulation, but there is nothing you can do to change it. She cannot reason. Anyone who has known her for any length of time will have figured out that she’s got dementia and know the stories are not true.

I do like Enderby’s idea of writing a letter explaining why you will not stay when she becomes abusive, because my mother cannot remember anything correctly that she hears, but if she has something on paper she will read it over and over and over. Of course, I would word it very carefully, be as kind and loving as possible while relaying that you will not allow her to be abusive. That is great advice, Enderby!

Believe me, I know this all too well...the best way I have found to handle this type of behavior from Mom is ; when she says she's going to cook the whole Thanksgiving meal when in reality I am the one doing it, that's one of the ' oh ok Mom, then I can have a day off and relax and make a joke out of it...but, for the time when she'd say ' you pulled that paper out of my hand and now my hand hurts' THAT's the time when the response would be ' No Mom, I actually grabbed you as you were falling , I would never hurt you !!!'.....there IS a difference in how you respond to their confobulations...but the MOST important thing to remember is NOT TO GET MAD AND YELL !!! Keep a low , same level voice tone and state your response. If they continue to say mean,untrue, hurtful things, I found the best way to say "I'm sorry you don't understand, I'm sorry you don't want me to do it that way, etc... and then say you have to leave. Just don't yell or say mean things back...they already are confused and upset. Another day means another day when they could be having more clarity, OR they have completely forgot about whatever it was that made them act/respond that way. Be matter of fact about whatever you need to do and then just do it. You can also offer ONE option and just say "that is the only other way we can do it - you're choice'....just make sure the other option is one of your choosing that you know is also another good way to do it.....In doing it that way, you are giving them the choice and then they think they are still in 'control'....that way, you still get it done in a better way for all and, they think they got their way. ....It works. It really does. But for the times when they are mean, then it's best to say I'm sorry you're upset, I love you and I have to go for now'....Then you don't get all upset either and keeps your blood pressure down !!! I just went thru this and it really works...

Oh Dear, you are writing my story too! I have almost the exact same situation. I have just decided to walk away if physically possible. I just smile and as cheerfully as I can, say, "OK, Mom, I've got to go now - - bye!" and spin around and walk away as fast as I can.
If I can't escape physically, then - I don't know - I'm not above firmly and loudly staring at her assertively in the eyes and saying "STOP IT! NO!" but I'm afraid dementia care experts might not say that's the best thing (I think they would say "make her feel emotionally safe, sympathize with her, lie if necessary, then switch the topic") but I have to say, that does help my sense of dignity. We're not talking to a Mind here. No sense in catering to non-mind. But - the idea of helping her feel emotionally safe is important. After I might firmly tell her NO, then I do try to switch the topic and tenor of my voice to be comforting and enthusiastic and encouraging about some completely different topic - "Oh, look at that bird over there / child running down the street" or even better - "What would you like for dessert? Chocolate? Lemon cake?" getting her thinking about food often calms her down. Hey man, whatever works. !!!!

Listen..you aren't going to be able to spend quality time with your mom unless you fully accept that her mind isn't working like a normal person. My mom got to the point where she thought I was her husband and it was very awkward at times, but when I would try to correct her it would end up causing her to get very agitated and after about a month I decided that if I wanted to spend any quality time with her, I didn't necessarily go along with her, but would ignore her statements and try to talk about something else. I hate to put it this way, but whether you realize it or not, your mom's actions and behavior are only going to get worse and you are going to have an enormous amount of patience. For me my religion really helped keep allot !! Always try to keep in mind there will come a day when you would love just to have a conversation with your mom, but she won't be there anymore. For me it helped keep things in perspective

Hi! My Mom will turn 82 this next Tues. My Dad passed away 5 years ago in Aug. I am an only child with multiple health issues myself. My Mon and I have had a love hate relationship for as long as I can remember. I grew up going to church every Sun and definitely do my share of praying for help and guidance with dealing with my Mother. Sometimes I have such guilt about feeling the way I do toward her knowing fully well God would not be pleased with my words and/or actions. However, all the stress my Mother imposes on me is beginning to take a toll on my health and mental state. I have been thru or to various councilors over the years who have talked about how to set boundaries when dealing with her, but when I try to do this she accuses my of being the worst daughter ever and how ashamed she is of me and tell s everyone how badly I treat her. I have recently come to realize that I will sadly never have a good loving relationship my Mother here on earth, but I pray that it could change someday in heaven.

My question to everyone is this: how do I tell if this is a dementia or early Alzheimer's

Continued:

Yes, how do I tell if my Mother is starting with dementia or early Alzheimer's or is she just using and/or playing her usual games with me as she has done for many years now? Nothing I ever do is right with her or good enough. I just want there to be peace for both of us.

it helps in some 'morbid' way to express "YES! me too!" regarding the following excerpts:

AmberA: "...negativity and character assassination..." and "...learn to respond to the false assertions for MY sake, not hers..." and "..hard-wired narcissistic ways are worsened by the dementia.."
Enderby: [she] only calls to ask for something or to relay something being 'stolen' - AND - when i visit and find the item, she says "oh i'll have to call the police back and tell them they don't have to spend time on it, because the housekeeper returned it." [she is never the one to blame. ever.]
Harpcat: "..if I reason with [her] it gets ugly.." i've become a 'yesman' i have 100% given up on 'redirecting' - NEVER works; DAMN she's sharp!
Quint41: "..amazed by how many narcissistic, abusive parents there are..." including the rest of your shared similar story; regarding enderby's letter: i believe my mom would rip it up and express anger toward me for WEEKS for writing such lies [truths]

just what is going on! some strange cruel joke of aging. rarely [never?] experienced or witnessed by our parents when theirs were aging.

Its part of dementia to act this way and in no way should you take it personally at all. My uncle was in a home and had a fantastic care giver who went above and beyond. His daughter loved this guy so much she tipped him often. When I visited my uncle I asked him "Hows Franco treating you" he said " that guys a criminal". So there it is.

JustOne,
I'm an only child too. You need to have your mom evaluated by a geriatric neurologist. Alert her doctor (before her appointment) that you'd like her tested for dementia. (Alzheimer's is one type of dementia.) The doctor can refer her to the specialist under the guise of checking out another ailment. Then you'll know if she's got it.

My mom and I didn't get along in my youth. She was narcissistic and I couldn't stand it. Later, when she was entering stage 5 Alzheimer's, she accused me of everything from stealing to throwing her on the floor to incest! At first I cried, then I tried to defend myself, then I got frustrated, then mad. As everyone does, I tried reasoning, explaining, screaming, ignoring then placating her by going along with it. I started limiting the amount of time I spent visiting her. If she repeated something too many times and I asked her to stop, I'd say I had to leave. That would work for awhile. As the dementia gets worse, nothing works. I learned to ignore most of it and redirect the rest. You'll get tired of responding and give up. In the mean time, limit your exposure and try to learn how not to care. It really doesn't mater what anyone thinks. My mother says her daughter (me) hates her and she doesn't like her either. I don't care anymore. She doesn't know who I am and can't retain it if I tell her.
They just have to be pitied for how "out of it" they are. Dear God, may we all escape this fate.

I'm going down to twice-yearly visits though I live just three miles from my mother. I avoided having kids so that I couldn't pass on what she has. If I end up as nasty as some of these women I'll dig a hole, take a bunch of drugs and jump in.

I had sort of the same experience today. Only not bad, just eye-opening. Several years ago I reconnected with two sisters who were very close to me in Jr. high and High school. One lives near me the other a couple hundred miles away. Last spring the one who lives far away, told us she was snowed in for two weeks last winter, no electricity, no heat, snow so deep on freeway all the snowplows were being utilized there. No one could get to her. She spent her time in bed. Most of her food gone, had to eat her canned food. She was believable because of where she lives. I have been worried about her because she is 86. I asked about her daughter, that is when she mentioned the snow so deep they couldn't get to her. I thought that was odd, but what do I know.

Today I at her Brother-in-Law's memorial service. I met her daughter for the first time, I mentioned how concerned I was about her and would it be possible to get a generator as her house is all electric with no fireplace. Her daughter said her mother exaggerates, lights weren't out for more than 18 hours, grandsons plow her driveway, If things were dire they have snowmobiles to get to her. She has studded tires, in essence didn't happen. Wow!! She has stuck to that story, was telling someone else about it today. This is months later. I guess it is her reality. It made me feel good and bad at the same time. Good she won't go through that again this winter. Bad that her mind is failing so bad that she thinks she went through it last winter.

OP hugs to you darlin'. This nonsense of false accusations is the hardest part of this disease. At least you have a diagnosis, and can move forward with it. I could tell you some stories that will make you cringe, but for now just know that you are not alone.

You don't have to tolerate acrimonious behavior towards you. Albeit as hard as is it, don't respond.

Dear Amber..your only prayer is to disengage with your mom's words and the judgement of others who have NO clue. It's sad and a bit of a lonely road ...I tried to tell a friend of mine who mom has been dissing lately that she probably has some dementia...I didn't even get into the narcissic nature she's always had....but he just ignored me and talked over me. It was for his sake I tried to tell him...but guess he didn't want to hear it....her next dr apt I'm going to request testing for dementia ...with her mental illness...it's hard for me to tell!! My heart goes out to you. I hope you have some friends who support you..you're going to need it. I pray a lot for strength and endurance

I truly sympathize. After only one year as a 24/7 caregiver for my formerly absolutely even tempered guy. He tells his children things that really hurt. But yet his sense of humor sometimes still glimmers a bit on occasion. I spend every day trying so hard not to take his accusations and name calling personally, trying to redirect his anger and not to argue. All I know to do is to go to my support group or to call one of the numbers I have for emotional support just to cry it out and talk it over. I learn the tools, but making them work consistently is so hard. There are days, (and nights), when I want to walk out the door and never look back. Then I think about the many good times we have shared - the laughs we've had and yes, try to feel what my husband must be feeling, and it does help. But it is very different if you have not had a positive relationship with your family member. Please know that there are a lot of people who share your sorrow, your frustration, and even your anger. I know that this "answer" is not really an answer, but I do understand.

Sometimes my father chooses the wrong word to express himself and doesn't recognize that he said something unkind. Those I usually ignore or try to supply him with an alternative word. He's shocked if I point it out to him. If he says something slanderous in front of others, I will gently correct him by saying, "That isn't exactly true. . . " and then minimize it so it's not a big deal.   This works for the moment. 

I know where you are coming from. I, as well, feel degraded at times from my Mom. Altho, my mother says she's being funny. But funny hurts. I have been embarrassed by and humiliated by my MOTHER! One day, when I had had enough...I told Mom that because of the way I felt she treated me (and gave the example), that I felt like never coming back to visit her. She cried....but it didn't change a thing. What did change tho, is that she got deeper into her dementia which brought her to the point of "realization" that she NEEDS me. I do believe that the "need" for her to "put me down" comes from the "need" to puff herself up. I find that calling her on it usually gets more respect from her for me. Sorry to say, tho, that it takes getting "sicker" (deeper into her dementia) in order for her to respect me. It is what it is. Hang in there. You may find the same thing happening to your Mom. Then....Mom may be a bit more tolerable.

The best advise I was given by a friend was just ignore what might be said they don't really know what they are saying and certainly don't mean to be hurtful.

"Character assassination" is just what I experienced at Thanksgiving directed at me by my husband, who suffers from inherited clinical depression. He was saying that he should visit his 62 year-old sister, who just moved into a retirement community (she has no ailments). When it was mentioned that I should come along for the visit, I said that I was busy going to Pulmonary Rehab 3 times a week, I work and I go to church. Like a five-year old, he said "You're lying; you've haven't been to church in months," That was an untruth, but I was shocked by the "you're lying" by a man of 67 years of age!