What to Do if Spouse or Partner with Dementia Accuses You of Being Unfaithful

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One of the difficult things about dementia is coping with its challenging behaviors, especially when they can be hurtful. For example, a loved one with Alzheimer's or another kind of dementia such as Lewy body dementia or frontotemporal dementia may become combative when you're trying to help her, yell at you and call you names, or think you're trying to embarrass or make fun of her.

Perhaps one of the most hurtful things is when a spouse or partner wrongly accuses you of being unfaithful.

For example, I knew of one woman with dementia who repeatedly and persistently accused her husband of cheating on her and just knew he was going to throw her out of the house because he didn't love her anymore. He tried again and again to reassure her and demonstrate his love for her, but still she didn't believe him. He became so discouraged and told me he was afraid she didn't love him anymore if she could think this about him.

Why Might False Accusations Occur in Dementia?

In dementia, delusions and paranoia can develop, causing the person to distort reality. So, rather than simply forgetting a loved one's name because of memory loss, dementia can cause the person to believe untrue things, such as the unfaithfulness of a spouse or partner. Paranoia can cause such distrust and fear that no matter what you do, you may be unable to convince your loved one with dementia that you really do love them.

How to Respond

How do you cope with this when you're doing the best you possibly can to love and care for this person? It's not easy, and there are no "3 Easy Tips to Make this Go Away!", but here are a few things to try. And, in trying them, remember that your goal is not to "win the argument" and prove something; rather, it's to comfort and care for your loved one.

  • Provide reassurance: This can occasionally work, and it's worth a try. Remind her of how much you love her and are committed to her. Be aware, however, that the person's delusion may be so fixed that you could reassure her repeatedly and get nowhere.
  • Take a Time Out: Remind yourself that the disease -NOT your loved one- is responsible for these thoughts and behaviors. Delusions, though clearly not accurate to everyone else, feel extremely realistic to the one who is experiencing them. Do your best to not take it personally by understanding that dementia warps the reality for your loved one. It can make it a little easier to cope if you understand that those hurtful words are coming from the disease, rather than your loved one.
  • Reminisce: You can try to direct the conversation to a special shared memory, such as when you proposed and she accepted, the birth of a child or a special trip you took together.
  • Distract: If you aren't able to reassure or reminisce, try distracting her. You can bring a favorite snack over to her or turn the television on to her show that she enjoys.
  • Validation: In general, I wouldn't encourage lengthy conversations about the accusation, but in some situations, it could be helpful to ask questions about what she feels you did. Perhaps she's fearful of a particular situation or person. Let her speak about her fears and work on not becoming defensive in response. This┬ámay be difficult emotionally but could help her process her fears.
  • Call reinforcements: Occasionally, some people respond well to one particular person in the family. For example, Is there one son who will be listened to and believed when others are not? If that's the case and your loved one is distressed because she continues to believe that you are being unfaithful, try having that son reassure your spouse or partner that you love her and will continue to be there for her.
  • Sense of humor: Sometimes, no matter what you try, it just doesn't help. The delusions and fear are so strong that you can't reassure her. You could try to use humor in this situation, perhaps by being self-deprecating. Try pointing out a funny fault of yours and say how glad you are that she puts up with you because you know that no one else could. As with the other possibilities, this may or may not be effective, but it can diffuse the anger, fear and hurt that she (and you) may feel at the moment.
  • Ask the physician: If this is a occasional accusation, do your best to roll with it. But if you're seeing persistent paranoia or distressing delusions, ask the doctor if medication is appropriate. Antipsychotic medications do have the potential for significant side effects, but they also can be helpful in relieving paranoia and delusions.

Sources:

Alzheimer's Association. Suspicion, Delusions and Alzheimer's. Accessed January 30, 2015. http://www.alz.org/care/alzheimers-dementia-suspicion-delusions.asp

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