"You stole my purse!"
"You are keeping me prisoner here!"
"You are trying to kill me!"
(To a spouse or partner) "You are cheating on me!"
There's nothing unusual about false accusations from people who have dementia. A false accusation of harm from someone you are working hard to help is hard to take. In the United States, there may be even be legal issues that arise from false claims that have to be dismissed by a social worker or a prosecutor's office. It is important to keep your cool, and to realize that false accusations are almost always manifestations of a diseased brain. Here are 10 approaches to false accusations from people who suffer major neurocognitive disorders that may help. Let's start with five situations many caregivers encounter.
"You stole my money!"
People who have dementia have to give up control over their finances. Their remaining financial authority may be limited to a little cash in a wallet or a limited balance on a debit card. When the concern is over a small amount of currency and coin, a useful response is to look for it with them. Then it helps go over recent events where the money may have been spent.
When the accusation concerns larger amounts of money, it helps to keep records. Even if the person you are caring for can no longer completely follow, say, balancing a checkbook, it helps to be able to show that you have taken care to keep track of income and expenses. Of course, the expenses of people who have dementia usually vastly exceeds their income. If you are caring for someone on government assistance, you may have to remind them that they no longer can access their assets as the price of keeping them in care.
"You're poisoning me!"
Someone who has dementia may suffer the delusion that a family member or a caregiver who cooks for them is trying to poison them. This is most likely to occur when the patient is served unfamiliar foods or foods prepared in an unaccustomed way. The solution? Provide familiar foods. Allow the patient to observe their preparation, or even to "help" in the kitchen. Take a bite of the food with your own fork or spoon to assure the patient it is safe.
"You stole my wallet/glasses/dentures/remote control!" (and so on)
When someone who has dementia can't remember where something is, they may conclude that someone had to have stolen it. It is easier for them to blame someone else for the missing item than to accept that they cannot remember what they did with it.
How do you respond?
- "Let's look for (the missing item) together."
- "I am sorry (the object) is missing. Can I look for it one more time?"
- "Maybe it was moved when we were cleaning. Let's take a look."
"You're keeping me prisoner!"
A formerly independent adult who now is restricted to the home may feel like he or she is in prison. Sometimes it is enough simply to talk about going to favorite places. Or it may be possible to "get ready" for an outing but redirect the patient's attention as time passes. Other times it is possible to go on a "field trip" outside the home or nursing facility for a change of pace.
In addition to dealing with these four common situations, there are six principles to keep in mind when dealing with false accusations from someone who has dementia:
- Remember that you can't win an argument with someone who has dementia. You will only make them more upset.
- Keep answers to questions short and simple.
- Keep calm, and stay positive. Use affirming body language.
- Make sure the home environment is calm. Don't let the TV blare. As much as possible, insulate patients from upset and upsetting people.
- Validate, then distract. Treat the patient's concern as legitimate, even if their analysis is faulty. Then move to another activity as quickly as possible.
Finally, don't take accusations personally. Remember that your loved one with dementia is trying to make sense of their reality — the only way they know how. Focus on showing that you care.