“Help, I’m steppin’ into the twilight zone” go the lyrics of the 1982 song by Golden Earring. The twilight zone, where things are not as they seem, was envisioned, and brought to the small and big screen, by the imagination of Rod Serling. I hear this song in my head each time I enter the assisted living facility where my Dad lives. (I tired quickly of the song when it was new; now I’m stuck with it!) Melissa and I have written about this before, (http://magnusinsights.com/2019/04/confabulation/ & http://magnusinsights.com/2019/04/same-as-it-never-was/ ) but I was reminded once again of it based on a report from my brother about a recent visit he had with Dad. My brother, Dale, reported a litany of semi truths heard from Dad. As I wrote in a prior post titled “Confabulation,” the details are often stated with extreme confidence in a way that, only if one was present at the event or otherwise had “inside” information, would one know that what was said was not reality. Dementia does this to a person, and it is tragically sad to see someone who was once very much on top of things fall into a “spiral, destination unknown” pattern (another line from the song). The point of this post is to address what to do when one finds that they are in the dementia patient’s twilight zone. When there, you are the odd person out. You have to live in the person’s twilight zone without fighting it. Fighting it by correcting the person is pointless. It will only upset them to be corrected, which will, in turn, upset you. Minor corrections or assurances are one thing. But, they will likely be forgotten in favor of what the person believes to be true. And, that may change by tomorrow, or even in an hour, or minute. The cognitive errors are usually harmless, though some might lead to confrontations by people who are unaware they are dealing with someone who suffers from dementia. But the non-dementia person in the discussion will rarely convince the dementia sufferer that what they think is not real. Biting one’s tongue can be painful and frustrating; learning to let it slide takes time. But this skill is important when dealing with the twilight zone of dementia.
Dementia is a strange disease that plays strange tricks on the minds of those who suffer from it, and sometimes, on the minds of those who interact with dementia patients. Based on my education as a psychologist, as well as my experience with family members and friends who suffer from dementia and mental illness, I know the preferred way to interact with someone who says and does “crazy” things is to go along with whatever is being said or done, as long as what is happening is not dangerous. For example, when David’s dad shows me a photo of his wife, David’s mother, and tells me the photo depicts a nice lady who used to work at a place where he lived, instead of correcting him or making him feel foolish by saying, “Herman, the woman in this photo is Carole, your wife!”, I smile and say, “Oh my, she is very pretty. Thank you for showing me this photo.” When David’s mom, Carole, speaks to me in gibberish, only once in a while saying anything that makes sense, I smile and tell her how much I have always loved her. I usually follow up by talking about my cat, a fun time we had together, or something else that will make her happy. The key in interacting with someone who has dementia (in any of its manifestations, including Alzheimer’s Disease, Pick’s Disease, Lewy body dementia, and others) is to maintain a positive demeanor, adopt a non confrontational attitude, and most important, keep smiling. It is amazing how much one can do to comfort someone with dementia by smiling, including smiling through a painful encounter.