Bad Manners and Brimstone

You learn to base your responses based on the stage of the person's dementia and how they react. In some instances, your can reorient the person, but you don't want to do that if it's something that would upset them. Other times, it's best to redirect their attention to something else. And yes, sometimes you just have to play along because nothing you say will convince them otherwise.

Examples:
When will/where is my spouse?
You know the spouse is deceased.
Oh, they went to the store and will be back later. You don't tell them they are dead over and over again.

Your sister said (insert vile horrible things here) to me...
You know you don't have a sister.
Oh, that's terrible, I'll have a talk with her.

Such and such had been stealing my things/money.
You know they are confused and are actually hiding their stuff themselves (this happens a lot!)
Oh, that's terrible, I'll get it back from them there next time I go over there.
No amount of arguing with them will convince them that their stuff didn't get stolen.

Good in person distraction techniques:
Give them a pile of washcloths to fold. Rinse, larger, repeat.

Give them a baby doll to care for.

Tactile fidget blanket.

Thanks for the responses.  They all gave me something to think about.

I guess I need to have more patience. That is something I have never had in abundance.

Over the last week Mom
 had a recurrence of an UTI  where she is so confused she can't even form words.
Asked if I had heard from her husband today (Daddy had a fatal heart attack in 1997)
Called to wish my husband a Happy Birthday) she couldn't remember his name but it IS his Birthday!)
Kicked an aide due to frustration and then worried like a Kindergartner if she's be reported to social worker

Never a dull moment with her

My Granny's doctor said to just play along as long as the delusion was not harmful. I would always have to reassure her that her parents were fine.  I told her that her parents had gone to stay with Aunt Viv. Technically it was true, they'd all passed away at that point. We'd talk about things that they would be doing at Aunt Viv's house, and I think it helped calm her.

That's kind.

I remember in the couple of weeks between their deaths, constantly lying to a family friend that "Dad is busy working today; he'll come and see you in a few days, but he sends his love".  It was so hard keeping the upbeat tone necessary, but Auntie G was so happy to hear that Dad was busy and would see her soon.

We knew that they'd soon be in the same place, and trying to get her to understand he had died would only cause her (immense) distress.

The distress that it caused us was so small in the context of his death [and her impending death], that it just felt the kindest thing to do.

Now [over two decades later], I'm so glad we did that, however hard it felt at the time.  The advice to "just agree with the person living with dementia" I don't think was prevalent then, and maybe if Auntie G hadn't been clearly failing we would have done things differently, but those little white lies were [I firmly believe] a kindness.

For years it was taught to "reorient" the person. That is fine for someone who is confused or delirious from being ill, but that doesn't work for those in the later stages of dementia. You don't want to make them relive their grief over and over again every hour or so. That's just cruel. It's perfectly fine to spin then a happy memory.

Another thing you can do (esp if you get frustrated) is to ask them questions...
My Gma in law had dementia...we were talking about how we lived in Germany and Gma in law said she also lived in Germany (she didn't).  My MIL was telling her she didn't live in Germany but we just said "Tell us about it.  What did you do there?"

This is one of those threads that I know will be so helpful in the future. I wish I had read this when my grandmother was nearing the end of her life. PVZFan mentioned utilizing improv skills, which is such a helpful idea for those of us who have that sort of experience. (The arts DO matter!) I just want to thank you in advance, as I just know that someone day this situation will be one that I am dealt and I know that I will recall your advice!

For years it was taught to "reorient" the person. That is fine for someone who is confused or delirious from being ill, but that doesn't work for those in the later stages of dementia. You don't want to make them relive their grief over and over again every hour or so. That's just cruel. It's perfectly fine to spin then a happy memory.

This. It still is good advice, when someone is delusional due to mental illness or some physical / chemical cause, not to humour and go along with their delusions (which can be a temptation; 'Yes, of course there really is an angel sitting on the windowsill. And he'll be very upset if you don't take your medicine like a good boy, so open wide') but to push back against them, and try gently to lead their thinking back to reality. But with dementia there's no way the person's memory and mental functioning is going to re-grow, so it's pointless and cruel to challenge their perception of reality unless it's distressing them.

In the same way, when small children forget something you told them or do it wrong, it's right to remind them and show them again, because their minds and motor capacities are growing and repetition will help them get there; but there's no point expecting people with dementia to learn new facts and skills, or re-learn ones they have lost.