Posted on August 31, 2010 - by Nurse Virginia

HOW TO TALK TO THE ELDERLY CONFUSED PERSON WITH DELUSIONS

“It is getting harder and harder to visit. Mom keeps saying Dad divorced her.” the visiting daughter said to the nurse. No matter how much reassurance the daughter provided that Dad never would have divorced her, and that he has passed away and is now in heaven. The elderly mom keeps coming back to the same topic of “the divorce.”

Reoccurring false ideas that are unshakable in the confused elder may be delusions.  It can become very frustrating to try to visit with a person who keeps repeating the same delusional thought.

Delusions in the elderly can be a way of explaining their life to themselves now. In this case the elderly woman’s husband had died several years ago. He had been very attentive and at her side ever since her stroke. Now mom is trying to make sense of his absence and her mind is trying to find an answer.

The daughter giving reassurances based on knowledge of her parents past, just doesn’t compete with the mother’s internal voice telling her this story that she believes is more probable. Because the mother has this fixed belief she finally tells the daughter “You always did take his side.”  And so it ends, because mom isn’t going to let go of this fixed idea, and it is best just to change the subject.

The best response the daughter can have is to remain calm and not react dramatically to what is said. It isn’t always necessary to agree or disagree; sometimes it is just important to be there. If it is an ongoing thought or worry that could be checked out – offer to do so and get back to the elder.

If the daughter would become adamant and even angry stating that the mother is wrong and “it just isn’t so.” The mother would most likely shut down and not think it safe to confide in the daughter her worries and concerns.

This situation would not be considered a particularly bizarre delusion because it is not unusual for people to get divorced. A bizarre delusion would be an ongoing thought that couldn’t possibly have happened. A bizarre delusion could be that the elder, states that the President doesn’t like them, or that they are personally responsible for some large disaster. Some idea so impossible, that it enters the category of bizarre.

Any change in level of confusion or increase in confused thoughts needs to be reported to the elder’s physician. When visiting the best thing to do is offer reassurances by holding the elder’s hand, making eye contact, use a low soothing tone of voice and if able redirect the conversation to a safe topic.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

Author: Please Get To Know Me – Aging with Dignity and Relevance

www.pleasegettoknowme.com