When Alzheimer’s patients become angry about delusions

January 8, 2008 by  
Filed under ALZHEIMER'S

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After she was diagnosed with Alzheimer’s disease, my grandmother never became violent or extremely angry. She had lived with some angry people, apparently, and I think she decided she couldn’t win by out-raging them. She eventually found other ways of dealing with conflict. She was involved in some family violence, but nobody ever told me if she hit back.

Most of the things that made her angry would have made other people angry. Her daughter had been mistreated by a husband a few decades earlier: time to let that go, but certainly a reason for anger. Siblings had fought over the family inheritance: also time to let that go, though she had reason for resentment. Though she didn’t remember the inheritance negotiations accurately, it’s probably true that they could have been more fair to her. She remembered the feelings of unfairness but not the details. So she reacted to and reconstructed the events according to her memory and her feelings.

The problem is that, especially when she had a fever, she insisted that her siblings had taken her share of the inheritance without saying a word to her. At first I contradicted her, thinking it would reassure her. Providing details to jog her memory helped little. Teaching her a story that was acceptable to her was a little more helpful. “Grandma,” I told her, “you signed papers at the courthouse.” She repeated that back to me several times over the next months, as if she was trying to get it into her head. When she woke up angry about it after that, I tried to sympathize with her. “Yes, sometimes people just aren’t fair.”

What seemed to help the most was to deal with her feelings and motivations. Instead of insisting that she remember the facts, I urged her to forgive her siblings. The theft was a delusion, but the unforgiveness was real. And it was time to let that go. She was a good Christian lady, and she understood that. So we could talk about forgiveness and unforgiveness (and how hard it is to forgive) rather than what happened in a courthouse twenty years earlier. Much more satisfying. Though I don’t completely agree with Julie Redstone’s spiritual view of Alzheimer’s disease, I do think that spiritual care for Alzheimer’s patients is vital

Trying to get someone with memory problems to remember everything – that’s probably not a good use of your time. When a woman asks every day where her husband is, it’s not polite to respond, “He’s dead” every day. The death of your husband is enough of a shock to deal with once, too much to deal with every day. When my grandmother asked where her dead children were, I usually told her, “They are resting.”

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