Caregivers grapple with idea of lying to dementia patients News Palo Alto Online hypoxic brain injury mri findings

"Therapeutic fibbing," "brief reassurances" or telling "white lies" has gained noticeable attention in recent months ever since journalist larissa macfarquhar’s article in the october issue of the new yorker magazine revealed how a growing number of nursing homes are creating nostalgic, small-town environments — lobbies designed to look like a town square, halls with lampposts and anoxic event street signs, rooms decked out with front-porch facades and rocking chairs — as a means of soothing the panic and rage residents with dementia often experience. These illusions, she reported, have proved successful in many situations, challenging decades-old policies and practices aimed at truth-telling at all costs.


"In my clinical experience, I’ve found that the right approach really depends a lot on the particular family. I have some who tell me that they cannot bring themselves to lie because the truth, even if about something painful, is too important to them. … I do think there are some cases in which the impulse to tell the can anxiety panic attacks cause high blood pressure truth needs to be scrutinized," said chiong, who will debate this topic with two other experts on thursday, feb. 7, during a public panel discussion moderated by macfarquhar and sponsored by stanford center for biomedical ethics and stanford’s mccoy family center for ethics in society.

"She found it very difficult over time to lie to her mother because her father had never lied, and it was a unique value in their home," bernstein recalled. "We talked about it at least 100 times." given the family history, the two also discussed the possibility that she could get alzheimer’s and what her preferences would be. "What we hit upon, roughly, was that in the early stages, when there’s still a lot of understanding, you try to be reasonably truthful but, as understanding lapses, moving to comfort, and she reluctantly agreed," bernstein said.

One time he pointed to his wedding ring and insisted he had to go to boston to find margaret because she was his wife and he had to take care of her. Deanesly played along, settling him into the car and letting him direct her to the airport. "It may have been 30 minutes or an hour that we drove around, up and down the freeway," she said. "Eventually we’d be driving down the street we lived on and he’d say, ‘this is it,’ and would point to our driveway. We’d go into the house, I’d give him an oatmeal cookie anxiété définition médicale and we’d start the bedtime routine, which is like putting a baby to bed, but he weighed 189 pounds."

Over time, jean learned to adapt her language to "respond to the moment." for example, her husband would say he didn’t want to go to his day program. She’d agree that he didn’t have to go, but would make sure to have him dressed, ready and seated in the living room. Then when the transport driver came to pick him up she would say, "’oh, there’s joe.’ and he’d get right up, put his coat on and go. This happened over and over."

In addition to avoiding talk of any family troubles, van horn recently hired a 24-hour, one-to-one caregiver for his father, who has lived at sunrise since 2015. "A lot of people would say, ‘why are you taking your father’s independence from anoxia meaning him and making him dependent on a caregiver?’ but my dad just needs that assistance, and that’s actually promoting his independence," van horn said.

If his father asks for a coke, van horn will tell him the dining room is out of coke. "I’ll grab a bottle of off-brand ensure and he’ll say, ‘OK, I’ll just take a sip or two’ and he’ll keep drinking it," van horn said. "I have no problem telling him there’s no coke — none at all — because I’ve been watching his calories and he needs the protein, calorie intake and carbohydrates."

Guest panelists include san francisco neurologist winston chiong, who treats people with alzheimer’s, frontotemporal dementia and other cognitive disorders of aging; university of california, riverside, philosophy professor agnieszka jaworska, who previously taught courses on ethical theory, moral psychology and medical ethics at stanford university; and physician marina martin, a clinical assistant professor at stanford, who works with post-acute rehabilitation and long-term care patients at webster house health center.

I experienced months of dementia because of an infection, just in my thirties. It wasn’t as bad as these patients, but it was bad enough that I almost went into nursing anoxic brain injury nursing care plan care. When I woke up in the morning, I really had no sense of who I was, where I was, how old I was, who I was related to. I would sit up in bed and spend my first moments of the day trying to place myself in time and the world anoxic brain injury. Apparently I repeated myself frequently; one of the times I would get most upset was when I was chastised for repeating myself.

Because of my age, I needed to know what was going on. In the above case, it would have been okay to tell me, kindly, that I was repeating myself so I understood what was happening, but it was so hard constantly feeling like people were yelling at or angry at me. I guess that was also because of my age, people thought I was doing it on purpose?

I do remember what it was like to experience not having any sense of familiarity with a spouse or friends of many years. I think that was one of the worst things. I used to look for identifying features on my spouse at night to be sure I knew who it was, and then there were many times I woke up with a start wondering who it was next to me. I was terrified, in a way, that my spouse would find out that I was experiencing this and it would irreparably hurt our relationship. (not that it was possible to hide the dementia symptoms, but that aspect of it was deeply frightening.) then when my spouse went on travel, I woke up wondering if I was alone in the world.

My spouse had to arrange our home so I could function, but still, I would forget to eat unless I was really hungry and wandered by the refrigerator — I just forgot that there was such a thing as eating, I was completely in the moment. I discovered my plants every day – pleasant surprise, but anxiety attack treatment at home then I would worry about who was watering them.

I think in that situation, it would have been a bad idea to lie to me, because I needed to know the truth so that in my more lucid moments, I was able to understand that something was really wrong. When people yell at you for repeating yourself a lot, you can’t avoid understanding that something is not normal. Again, it probably would have been just as helpful if people had told me, in a concerned way instead. But if people had simply humored and lied to me, I might not have gotten the help I needed in time to treat what was wrong.

My spouse’s uncle died of a brain tumor far too young, and when those symptoms began, everyone chalked it up to early alzheimer’s because of the family history, delaying the real diagnosis way too long. Long before the diagnosis, I was very upset hearing that no one was considering anything else, but there was nothing I could diffuse anoxic brain injury do. Because of his age — and he wasn’t THAT old — everyone just assumed there was nothing to be done, and that robbed his children and grandchildren of years and even decades with him.

I think what is described above is perfectly appropriate and kind. Families who are up to it might consider jotting down notes as things happen and when they are able, putting together a guide book for others with how they handled such situations, because despite my personal experience, I found it extremely difficult to interact with a dear friend who died of alzheimers at a stage when she was very confused. Part of my problem was that in my own situation, I needed people to be honest anoxic brain injury post cardiac arrest with me — even when hearing the truth was really upsetting because it made clear just how wrong things were going — it would have furthered my distress to think I was being humored, it wouldn’t have done me any favors. So I didn’t know how to judge when/how to use a compassionate lie for her when that was appropriate.

We were taught in nursing school to never argue with a dementia patient. If this meant harmless deception, it was employed. One retired shoemaker from bolivia always wanted his “pesos, sepattas and his casa.” we would walk with him during the night shift and eventually he lost focus. Who knows what home he wanted—maybe someplace in bolivia 1957. This man was with us 6 months. Another skinny octogenarian was an italian WWII survivor, who frequently would “hide from the germans.” she gathered shoes from the other patients to “ give to the shoeless.” how do you orient people who are living somewhere else in their minds? You comfort them as best you can and agree with absurd thoughts. Lying? Maybe. But safety first. Why orient to the point of rage? My patients were in stages where they attacked. Could be a son they no longer recognized like a 58 year old former banker. I remember them all. Heartbreaking. I was dealing frequently with rage. You bet I lied. The banker’s son cried as his father introduced himself to his own son daily hypoxic brain damage recovery. As far as the banker was concerned, a stranger was trying to bathe him. Attack. So the son became a hired aide who desisted in trying to orient his father.