A Tough Conversation

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Usually, when a visitor to our community tries to “correct” one of my residents, I jump in and try to save the conversation. For example, if a resident’s daughter is visiting and says, “No, mom, don’t you remember, dad died years ago!” I will try to swoop in and change the interaction so that no one gets upset.

When that same conversation is between two residents with dementia, though, I’m kind of stuck watching it happen.

The interesting thing about working in a community that’s in a small town is that many of the residents knew each other from years ago.** Two of my residents, Ellen and Isabelle, are related by marriage. **Distantly related—cousins, in fact—but still related. Ellen is very high-functioning. She’s living in our Memory Care because she needs reminders, cues, and other help to keep her safe. Up until recently Ellen was actually living by herself in an apartment, but that was very dangerous.

Isabelle can do most things for herself with cueing and assistance, but her short-term memory is awful. **She can’t remember anything that happened more than three minutes ago. **This makes the pair’s interactions difficult to listen to.

“Ellen! What are YOU doing here!” Isabelle cried excitedly, spotting her cousin-in-law in the hallway.

“I live here, my room is right down the hall,” Ellen replied, trying to be kind about it.** She knew that Isabelle’s memory was poor—she just didn’t realize that her own memory was impaired, too.**

“Hey, Ellen, can you get someone to call my husband, Jim?” Isabelle asked. “I want him to come pick me up.”

Ellen paused. I could tell that she knew Jim was dead, but she was mystified by Isabelle’s current state of mind.

“Honey…I don’t think Jim can come pick you up today,” Ellen offered, slowly. “He’s probably busy,” she tried.

Isabelle shook her head. “Nah, he’s retired! Can you call him for me?”

Ellen sighed. “Honey…Jim is dead. My husband is dead too. I’m sorry…but don’t you remember? We went to their funerals together.”

“What!” Isabelle yelled. “Jim isn’t dead! I just saw him earlier today! He drives a truck,” she reasoned.

“No, Isabelle,” Ellen said, growing impatient. “He died years ago.”

“Ah, you’re crazy, Ellen!” Isabelle shook her head. “Jim isn’t dead.”

Ellen gave up. “Okay, Isabelle,” she said. “I’m going to go to dinner now.”

Isabelle paused. “Hey!” she called up the hall. “Ellen! Can you get someone to call my husband!”

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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