jmgoyder

Dementia Replay

My husband has PDD (Parkinson’s disease dementia) and has been in a nursing home now for over 18 months. This was a heartbreaking but mutual decision that has ruptured our little family of three (we have a 19-year-old son), but we are gradually coming to a place of acceptance. Husband’s memory dims and distorts haphazardly but he is mostly lucid. However, over the last few weeks, he has referred several times to some unfortunate events that took place in our lives years ago, as if they are happening now. In this article I discuss what I’ve termed dementia replay, and outline ways of alleviating the stress this sometimes causes the person with dementia if the memories are bad. I also suggest ways of reconjuring good memories.

Have you ever wondered what that elderly person, sitting in an armchair in the nursing home, with a blank, or grimaced expression, is thinking? Have you ever wondered why that gentle, gentle woman suddenly swears at the air? Have you ever wondered why that man who dribbles from his mouth also dribbles from his eyes?

For people with various kinds of dementia, I believe that these sad and/or angry expressions, verbal and non-verbal, might be due to the memory’s ability to replay past events as if they are happening now. This is exactly what seems to be happening to my husband lately.

To give you a bit of context, during the 1990s, the announcement of our engagement was met with fierce opposition from a family member with whom my husband was in partnership, and lately Anthony repeatedly asks me has this person taken our farm. He often asks me desperately not to sign anything because he is obviously remembering being coerced into signing things for his ex-business partner. This latter is the most recurring replay.

In between these episodes of dementia replay, Anthony is in touch with the now, however this can change in the space of a minute, which is disconcerting for me. The more he sees of me, the less likely these episodes occur so I try to see him every day and I speak to him on the phone several times a day. Nevertheless, during our goodnight phone conversations, he is sometimes concerned that he has lost his farm. This is a good example of dementia replay and it mostly happens between the twilight hours of 5 and 9pm. That is a lot of hours for anyone to be anxious.

During the last week or so, it has been distressing for me to witness how dementia replay has allowed the past events, resolved long ago, to re-insinuate themselves into the present so much so that my reassurances are often forgotten by my husband by the next day. No matter how many times I say that the situation is all over, it keeps creeping back into his sentences. He wants to visit, he wants to reconcile, he wants to reprimand, he wants to keep our farm safe from harm.

How to handle dementia replay:
1. Reassure the person that everything is okay now. And, if that doesn’t work,
2. Change the subject. And, if that doesn’t work,
3. Make up a story that contradicts the unpleasant memory and stick to it.

How not handle dementia replay:
1. Do not agree with the person’s anxiety.
2. Do not dismiss the person’s anxiety.
3. Do not engage in unpleasant reminiscences to do with the person’s anxiety.

If an unpleasant situation is over in real life/real time, do not buy into dementia replay in order to try to fix it all over again. One of the mistakes I made recently was to arrange for my husband to meet with the person who is more or less estranged. It was only when I realized that Anthony wanted to clear the already cleared air, that I knew I/we would be replaying a toxic situation, so I cancelled.