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Musings on Dementia

I received the most beautiful email response to my musings on dementia yesterday from one of my employees. (I am really touched by all the responses!) Her father-in-law lives with dementia, and she recently visited him in one of the care homes that I have been involved with for many years. It was his birthday. She writes that “he no longer recognises her or any of the grandchildren”. Yet, when one of the Care Partners helped him, he smiled and told the Care Partner “This is my goose!”, pointing at his daughter-in-law. Her immediate thought was that he mistook her for his wife.

This is something that happens all the time with people living with dementia – they will get family or friend connections wrong. They would often refer to someone as their daughter when in fact it is their spouse, or vice versa. How do we explain this?

People living with dementia are not emotionally dead, as we discussed before. In fact, they are highly attuned to their own emotions, and often freely express their emotions. The fact that they might get the connection wrong as to who you are or where you fit into the family tree is not important. What is really important is the message behind the words. The statement “this is my goose” tells me that this man was expressing a feeling. In this case, a feeling of love and affection. Saying “This girl makes me feel young and loved” – as if it was indeed his “goose”. He might not have been able to name the person, but he sure as hell knew how this person made him feel!

Many older people living with dementia would say that they need to go home to their parents when we know that their parents died many years ago. Again, this could perhaps be an emotional expression of longing to connect, a need to feel loved, like they felt when they were small, living with their parents. I often hear “I must go home, my children are waiting for me” or “I must go home to go and cook for the family”. These are expressions of emotions, the need to belong, a need for security, or a need for connectedness.

What would be the proper response from us? Engage with them on the topic. Ask questions like “Do you miss your home?” Or start a conversation like “You must have been a wonderful mother for your kids”. Perhaps “I can see you miss your home and your family – come, I will give you a hug”. If someone talks about a spouse that died as if they are not dead, af rm the emotion, not the facts. “You must have loved your wife dearly. Shall we look at her photographs again?”

“This is my goose” – what a beautiful expression of love and emotion. Maybe next time respond with “And you are my beloved”.

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