In this article we address a question we are often asked by visitors to residents in our specialist dementia care homes: should you correct someone with dementia?
Memory problems are one of the symptoms of dementia, and indeed, one of the most overt. The memory loss is very real, and it may not be consistent, or even seem to make sense to the onlooker. You may wonder why one day they can talk about family members in the here and now with utter clarity, and then the next moment forget that person exists.
But the memory loss is more pervasive than this. It can actually end up appearing that the individual is lying, about seemingly small or large things. There’s a real temptation to correct them. But is this the right thing? Should you correct someone with dementia when they are wrong about something?
Memory loss is disabling. It may seem intangible, especially in its milder and more moderate stages, but it is very real. You would not ask someone who is deaf to hear. You cannot ask someone with memory problems to remember. But, having all experienced incidences of memory loss from time to time, you can wonder if you should nudge the person to remember, through correcting, in the same way that you would remind the deaf person to turn their hearing aid on.
The problem is that rarely, at any stage in the progression of memory loss, are reminders and corrections the kind thing to do. In the early days, these corrections act like small daggers, bringing attention to the fact that the individual is struggling with their memory. Later on, reminders and corrections can lead to confusion and genuine distress.
Your reaction to memory loss is the one thing you can control. And this is one area where that really matters and can have either a positive or a negative effect on the sufferer.
But if you shouldn’t correct someone with dementia, how should you respond when they say something incorrect? How can you communicate effectively?
First of all, it’s essential to remember that the person is saying their reality. It’s their truth. Whether it’s that they have just eaten a pear that you know doesn’t exist, or they don’t have a daughter who very much does. Right now, at this moment in time, that’s their truth. They are not lying.
Remembering this yourself can help you to take the statement less personally. This can give you the resources and focus to manage the experience. You can hold onto your truth, whilst respecting that their reality is real to them. You don’t need to contradict them. It might help you to think of it as ‘it’s the disease talking’ as this depersonalises it. It is hard, and having compassion for yourself is also important.
Agreeing doesn’t mean they are right, or that you will make their dementia worse
Refraining from correcting someone with memory loss will not make their dementia worse, or exacerbate their symptoms. You cannot slow the disease by arguing with it, explaining to it, or reasoning. Unfortunately, it will progress.
However, refraining from correcting someone may actually alleviate some other symptoms. They are less likely to experience confusion in this instance, or display aggressive behaviour.
There’s a difference between correcting someone when they are mistaken and actively going along with their version of reality. It is understandable that you want to know what to do, and what’s the best way to communicate. For example, if an individual believes they are doing a particular job, or have a child of a particular age, should you ‘play along’?
There are different opinions on what is best to do in these situations and much of it does depend on the individual and the stage of memory loss progression. Indeed, there is a therapy, called validation therapy, which actively works with going along with the version of reality that the individual is presenting.
We find that the best way to respond is to always focus on being kind. Not correcting is kind. It then may be kind to go along with the story to help promote feelings of calm and happiness. However, you may prefer, or feel it is best, to try distraction, bringing their attention away from the incorrect situation in their mind.
It can also help to use short and clear sentences, leaving longer than usual gaps for processing. We’ve explained more previously about how to communicate with someone with dementia. Be patient and reassuring, and try to remain positive.
If you are in a situation with an individual with dementia and they are asserting something at odds with reality, remember these 4 key things:
Telling them may cause embarrassment, distress or anger. It is not helpful to correct them. They may realise their mistake of their own accord, or they may not. This may even involve taking the blame for something, which can be hard. However, it is the best approach to take with someone with memory loss.
Arguing with someone with dementia is unkind and will not be productive. You cannot ever win. It will result in them becoming distressed or angry, neither of which is constructive. If necessary, distract them and change the subject.
One of the most common ways of correcting someone is to ask “Don’t you remember…?” This form of nudging is unlikely to be helpful and can lead to a lot of confusion. For example, saying “This is Alice, do you remember her?” If they remember, you will see appropriate signs and if they don’t then reminding them can be distressing. Instead, meet them where they are with their memory at that moment.
It’s very common for someone with dementia to believe a spouse, sibling, friend or even parent, is still alive. This can be particularly heart-wrenching for loved ones to deal with. However, reminding them can be very upsetting for them, and is unlikely to ‘stick’, meaning that they need to go through the distressing news over and over. If they ask you directly, answer truthfully, but otherwise, try to offer distraction away from the topic.
The memory loss with dementia is distressing, and how you react is often a matter of individual judgment. However, if in doubt, do not correct them, and always focus on kindness.