Polar realities

By now you should have a pretty good grasp of the fact your reality and your loved one’s reality are sometimes completely different.  This dementia-induced gap reminds me of the story about the blind men who after touching different parts of an elephant each came up with their own description of what it must look like. 

None of them were “wrong” even though each had a slightly different sense of reality. 

One gentleman touched the trunk and said the elephant was snakelike.  Another touched its ear and perceived it to be like a fan.  A third touched its leg and said it was a tree trunk.  Still another felt its side and said its like a wall.  A fifth man touched its tail and felt it was like a rope.  The last one touched its tusk and described the elephant similar in shape to a spear.

Each gentleman will tell you their belief (reality) of what an elephant looks like if asked but their portrayals will be completely different one from another.  But remember, nobody was wrong which makes this a great parable we can use to remind us we each have a somewhat limited and very personal concept of reality. And that’s okay!

Gestalt psychology states, “the whole is greater than the sum of its parts.”  We can easily see the value of this in the parable.

Confibulation is a beneficial tool

The use of confibulation allows you to interact with your loved one constructively during those moments when two opposing realities collide; theirs and yours.  Very often in those moments we want to set the loved one straight, “Mom, you’re 84 years old.  You didn’t just give birth. But if that’s mom’s reality, do you think that’ll really change anything?  There’s a better way to interact and that’s through the use of confibulation.

Unlike confabulation where you tell a little white lie to to save yourself from getting into trouble, confibulation is telling an untruth solely for the welfare and benefit of the person you are interacting with. 

Confibulation is used for example when your loved one becomes overly stressed because their reality suddenly tells them something distressing like they have no money for food or rent; a very common dementia-induced fear in those who went through the “Great Depression.”  They won’t eat, can’t relax, and unless someone intervenes, their mood escalates towards hysteria. 

Use confibulation to touch their feelings

Using confibulation is yet another means of communication that actually maintains a healthy mood state while providing a continued sense of calm and wellness, especially when two different realities collide.  It’s another way to validate their feelings.  Within the conversation there is

1. 1. 1. a gentle amount of guidance,
      2. there is respect and acknowledgement to their cognitive age while still being respected as an adult,
      3. the goal of the interaction itself is to increase and strengthen a sense of wellness and security.

Confibulation addresses and validates the loved one’s feelings and emotions, not the content in what they are expressing.

Confibulation + validation = peace

Entering through the locked double doors in a dementia facility one morning I found resident Alma pacing back and forth in front of the fireplace, tears streaming down her face.  “Alma!  What has happened?” I asked.  “Why are you so very, very sad?”  Whispering in my ear so others couldn’t hear, Alma softly said, “I don’t have rent money and I can’t buy food today.  ALL my money is gone!” 

Validate the emotions

“You don’t have rent money?  All your money is gone? Oh you must be absolutely sick to your stomach with worry!  Who told you that?” I asked. 

“I just talked to the lady at my bank and she told me I don’t even have a nickel to my name,” Alma cried.  “Some lady at your bank said you don’t have a nickel to your name?!  Wow, that must have really terrified you!”

“Oh gosh!  Figured it out!  I bet you spoke with Susan.  I’ve dealt with her before.  I’ll call the bank to see what’s going on,” I said (all confabulated).  I then left Alma to go take care of completely unrelated business.  Once that was done I came back to her.

Exhibit positive body language, intonation, and caring facial expressions

Bursting with excitement I gaily said,  “I called the bank about you not having any money.  They checked your account for me and sweetheart!!!!  Money definitely is not your problem as you have plenty in the bank!  Mind if I start calling you ‘Your Majesty?'” I jokingly asked.    

Instantly tears began streaming down Alma’s face.  Tears of joy this time upon hearing the good news.  Hugging me and thanking me, her trauma was over.

Now she was ready to go have some fun.  Being a dancer I put on a CD that played her favorite Big Band Era music.  “May I have this dance,” I asked.  From that moment on Alma was dancing, laughing, and singing her morning away without a care in the world. 

The truth of the matter

You know and I know I never called her bank.  I didn’t even know where Alma banked.  She needed a resolution to her distressing “problem” or her day would have turned into a complete nightmare including the addition of mood-altering meds, inducing her to sleep the rest of it away.

Confibulation gave Alma the peace of mind she needed in the moment she needed it most.  Guarantee:  Any unresolved traumatic event that may have happened within a loved one’s life will very often come back later to “haunt” them usually somewhere in middle to late Stage II.

PTSD can make or break a person, depending on how it is handled.

Know a loved one with PTSD issues?  Please read, “Where’s Marty?” to see how one resident in a locked dementia facility was able to work through her PTSD after dementia had set in.

Psychosocial Encouragement

• Always go to their reality.
• Never correct their statements.
• Validate their feelings by echoing their own words.  Intuitively this will tell them you heard their need.
• Use appropriate body language, intonations, and facial expressions.
• Let them breath in your empathy and compassion.
• Take a firm stance and show them you are bigger and stronger than there “problem.”