Geriatric Psychiatrist Questions Geriatric Psychiatrist

How to explain what's going on to someone with dementia?

My mother has dementia and doesn't understand why I can't see her at this time. How to explain what's going on to someone with dementia?

4 Answers

I think it would depend on why she does not understand: (1) for example, does she just very quickly forget what you are telling her, (2) are her abilities to understand language seriously affected, (3) or as a result of dementia, is her thinking just more rigid. If the issue is primarily memory, sometimes writing somewhere clearly visible what day and time you will visit, as well as having a daily day/date on there could be helpful. Some individuals have given such individuals a written note stating this in their pocket so they are reminded whenever they check. For many individuals with dementia, anticipatory anxiety about future events is very troubling and sometimes it's best not to give them too much notice that they will then brood over. The Alzheimer's Association ( has wonderful tips on communication skills that you may find helpful, as does the book The 36 Hour Day.
I am not sure why you cant visit now. I am not sure how much your mother can understand and integrate new information. If you can reach out to her frequently by phone or through video calls, perhaps the NH staff can help here. Some people with dementia may actually do better without constant reminders that their loved ones are not with them, meaning frequent calls may make the person more agitated. So less communication maybe better. Making sure your mother's room is decorated with photos of family and things that make it homelike usually are comforting things as well. With dementia there is not a " one size fits all" plan of care. Each person requires their own individualized care plan Theresa M. Redling, DO, FACP Chief, Geriatric Health and Disease Management Medical Director Maida Geriatric Institute at Cooper Barnabas Medical Center Assistant Clinical Professor of Medicine Rutgers New Jersey Medical School Office 973-322-7636 Fax 973-322-7673
This is a challenging problem. If their short term memory is quite impaired, they won't remember you telling them what's going on. When you do, they might not understand. I would simply say that I can't get there right now, but will do so as soon as I can, without trying to explain the whole situation.
It may be impossible to explain current events to a patient with dementia. Sometimes visual aids may be of benefit. Don't try to convince the patient of certain things if they don't agree or are living in a different time period. The best you can do is accept that these patients have a neurodegenerative disease that impairs memory and recognition.