Why Arguing with People Who Have Dementia Backfires

Arguing/ Steve Debenport E+/ Getty Imagse.

Here's the scenario:

Your loved one with dementia insists that it's time for him to go to work, even though it's been several years since he worked at his job.

Or, she tells you that her mother was there to visit a couple of days ago and that today, she is going to go see her mother at her house.

What do you do? Do you explain that he doesn't have a job any more? Or do you tell her that her mother did not visit her recently and that she can't go over to her mother's house because she has died?

While there are times where reality orientation is appropriate and beneficial, most of the time, you won't get very far by logically pointing out the facts. This technique often results in an argument, and those are difficult to win, especially when they're with someone who has Alzheimer's disease or another kind of dementia.

Why Does Arguing Backfire?

1. Your reality is not the same as his reality. He does not remember that he quit his job, so it makes no sense that you are saying that he did. You can make your point over and over, but this is unlikely to convince him. Likewise for the woman planning to visit her mother today. She thinks you're the crazy one to suggest that her mother isn't alive and well. Her reality may be based in life from fifty years ago, but it's where she's at and where she believes everyone else is, as well.

2. Arguing may increase her agitation, anxiety and emotional distress. Not only are you unlikely to convince her and "win" the argument, you will also likely increase her frustration and trigger some anxiety and agitation- and that's a definite no-win situation.

She may now feel anxious about the health of her mother and sad that you won't drive her over to see her mother. The man described above may feel angry that you don't believe him, worried about being late for his job and tense about arguing with you.

    3. Arguing may trigger challenging behaviors. Some times, arguing can ramp up someone's anxiety and agitation to the point that he will have a catastrophic reaction to your suggestion that he sit down and enjoy his breakfast while it's still warm. She may begin crying and calling out to her mother repeatedly, wondering where she is. You're unlikely at this point to be able to help her take her shower or get dressed for the day.

    What to Do Instead

    There's no perfect approach that always works with everyone, but here are two tried-and-true techniques that often are effective.

    Try using validation to meet the needs and address the feelings underneath the statement of the person with dementia.

    Also, consider distraction. You can often use distraction by engaging your loved one briefly about the topic on which she's focused, and then gently guide her to a different thought or activity that is meaningful to her.

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