How to “stop walking on eggshells” in dementia caregiving

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I had Ansel’s wife, Megan, at their home. Ansel had vascular dementia and was in a moderate stage of the disease. Ansel’s wife, however, was bearing the brunt of his disease herself. “I’m exhausted,” she sighed when we sat down on the couch to talk. It was clear to me immediately that Megan was doing the absolute best that she could, given the circumstances.

Megan explained to me that, when the caregiver from their home care agency arrived, she would take that time to grocery shop, get her hair done, or just see some friends for a couple hours.

“I feel like I’m walking on eggshells,” Megan explained. “He constantly talks about how he doesn’t need any help, and can take care of himself when I’m gone…but I know that’s not true! So I tell him, ‘Look, you can’t stay here alone, you aren’t safe,’ and then he gets mad.” 

Megan did her best to talk to her husband about her concerns, but these talks just caused arguments. I understood why she felt like she was walking on eggshells: she was afraid to say the wrong thing, but she was afraid to not say anything at all. 

“Instead of walking on eggshells,” I said, “Walk away from the eggshells.”

Megan stopped and thought about this. “Walk away from the eggshells…” she repeated slowly to herself. “So, you mean I should avoid the conversation entirely?”

“That’s right,” I nodded. “You’re never going to be able to convince him that he needs home care, or that he has dementia, or anything like that. So, just walk away from the conversation: change the topic, get him focused on a new activity, whatever you need to do.” 

If you’re reading this and thinking, but how can you make it sound so easy?, I fully recognize that this isn’t easy. Disengaging isn’t easy. But, it is better for both you and the person you’re caring for. You will get nowhere with arguments, logical statements, and attempts to “make them understand.”

I called Megan a couple days later to follow up with her and see how things were going. “I’ve been avoiding the eggshells!” she exclaimed proudly, and I could hear her smile over the phone.

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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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