How to handle awkward questions from someone with dementia

At some point during the dementia journey, your loved one may ask you something that you find tricky to answer, mainly because you don’t want to upset them. Here’s how to cope with difficult questions

Could this be you?

You feel very uncomfortable telling outright lies to a loved one with dementia, but always telling them the truth can be really distressing – especially when it concerns people or possessions which are long gone.

Here’s some of the most common sorts of questions you might face – and a few ways to deal with them.

1. Questions about loved ones who are dead

 ‘Where is my mum/dad/husband/best friend?’
Why: As the illness progresses and their recent memory disappears, events from the distant past can become very vivid for people with dementia. So if they ask after a loved one who died decades ago, it could simply mean that they’ve been thinking about them recently or that something has triggered a memory of them that they’d like to share.

Try saying: ‘Oh, I was just thinking about them myself. Remember that day we….’
Why: You aren’t ignoring the question, just side-stepping it and leading the conversation into a more pleasant area for both of you.
Or
 ‘I’m sure they’d love to see you but they can’t get here. Tell me more about them, what would they say if they were here with you?’
Why: This is a satisfying answer which isn’t, strictly speaking, a lie but does involve being fairly economical with the truth
Or
‘They can’t see you because they’re at work/shopping/at school.’
Why: Now you definitely are lying, but many people (experts and carers) believe this sort of therapeutic lying is acceptable and sometimes necessary if it’s in the best interests of the person with dementia.

2. Questions about where they live now

‘When are we going home? I want to go home now! Can you call me a taxi?’
Why: People with dementia can become very anxious and afraid if their environment suddenly feels unfamiliar. If they’ve recently moved house – whether into a care home or in with family – this sort of question can crop up frequently.

Try saying: ‘Who will be at home now?’
Why: ‘Home’ could mean lots of things for people with dementia. It could be their childhood home, or their home when they were newly married. This sort of question allows you to explore what time period they’re talking about. Once you know, you can steer the conversation towards general chat about the era.

Tip: Look beyond what they’re saying
If they suddenly seem to hate where they’re living now it doesn’t necessarily mean you made the wrong choice, so try not to take it personally (though if you’re concerned about a care home there are checks you can do). Instead, consider what feelings may have led them to say this and how you can help them cope with the feeling. For example, could you put on some favourite music or look through a favourite photo album to remind them of familiar places and people?

3. Questions about their illness

 ‘What’s wrong with me? Am I going mad?’
Why: Many people with dementia have moments of clarity and lucidity when they suddenly seem to understand exactly what’s happening – and are, understandably, terrified.

You say: ‘You certainly are not going mad!’
Why: You are telling the truth and providing absolute reassurance, which should help to ease their fear. Whether you choose to elaborate your answer further – for example, by saying, ‘you’ve got memory problems’, or just telling them they have vascular dementia or Alzheimer’s  depends on how much you think they need to know in order to feel calmer.

Still struggling?

Try not to worry. There are no right or wrong answers to any awkward questions and, sadly, no perfect solutions either. Balancing the need for respect and truth with kindness and compassion is a daily, sometimes hourly, struggle for anyone who cares for a person with dementia. Remember, you aren’t alone and you can get support from someone who understands right now by joining the Unforgettable Dementia Support Group.