“Dad knows he’s 98 but still thinks he’s working! How is this possible?”

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I had the most lovely conversation with a 98-year-old man a couple days ago. He is in a moderate stage of dementia, very friendly, and clearly very passionate about the work he used to do.

When I meet people with dementia, I always quickly assess what REALITY they are living in. I want to ensure that I Embrace Their Reality the best that I can, so I use context clues to figure out where that reality is. “What did you do today?” I asked Dan cheerfully. “Oh, not much,” Dan replied. “The boss was at work, so we lazed around,” he laughed. “We do less when he’s there!” Okay, so that clued me in immediately: he believed he was still working. Dan and I got into a great conversation about his work, all in the present tense.

Out of sheer curiousity, I worked Dan’s upcoming birthday into the conversation. Often, people think they are much younger than they actually are. “How old will you be on your next birthday?” I asked. “Ninety-nine!” Dan replied proudly. Okay, so he actually knows his numerical age. We talked about that in the present tense, too.

What’s SO interesting to me when talking to people living with dementia is how they speak about their world. Their world is often an amalgamation of facts: some current, some past, some never. The KEY is to figure out where that reality is, listen, understand, and live in it with them.

Dan knew that he was 98, but he also believed that he was still working. If we think logically, these two things cannot exist simultaneously. But, in his reality, they did! People with dementia will often take facts from different parts of their lives and combine them together to create a new reality. This new reality makes perfect sense to them—even if it doesn’t make sense to us.

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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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