Anne (50) walks to the front door of her apartment and enters. She moves into the kitchen, where she stands by the coffee machine and carefully inserts two pods. She places two cups underneath, presses the button, and watches the coffee pour. As she does so, she answers a question from her brother, Leendert (off-screen): “What does your day at the sheltered workshop look like?”You see and hear Anne describing her workday in a systematic, precise manner, using multiple ways of expressing time—for example, both “a quarter to ten” and “11:45.”
Anne (60) and Leendert are arguing in the open kitchen while Leendert cooks. Anne insists it cannot be dinner because, in her view, it is still afternoon. She “proves” this by pointing to her watch, which reads 7:10. “That’s afternoon,” she repeats angrily. Leendert tries to convince her that it is not afternoon but evening, offering various forms of “evidence.” Anne, however, continues to point at her watch and insists that it is afternoon. Only when Leendert gives in and concludes that they are going to have lunch does Anne become satisfied.
The theme of this teaching material is the confusion of time.
Dementia affects a person’s sense of time, a symptom often referred to as confusion of time. People with dementia may also experience confusion in other areas, such as orientation to place and to people. Disorientation in place and person is addressed in other cases. . voor meer informatie. Ook op andere terreinen, zoals plaats en persoon, raken mensen met dementie ‘de weg kwijt’. In andere casussen komen desoriëntatie in plaats en persoon aan de orde.
The case “I am Anne” explores Anne’s life story and the onset of her dementia, including early signs such as getting lost. It also provides important context for the other cases; therefore, it is recommended to watch I am Anne again.
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There are different ways to respond to the “alternative truth” experienced by a person with dementia. One approach is to teach and reinforce the factual reality, attempting to convince the person of the “real” truth. This approach is known as reality orientation. Another approach is to set aside the factual reality. In this case, you either go along with the person’s experience or do not challenge it. This is known as validation.
What works and what does not varies from person to person and from moment to moment; outcomes are often unpredictable.As a professional or informal caregiver, you are the one who must find the most appropriate response. Along the way, you will repeatedly encounter questions—often with ethical implications.
Would you like to learn more about reality orientation and validation? 'The caregiver’s companion to intellectual disabilities and dementia: 100 real-life questions and answers' will be released soon. For now, it is available in Dutch.
