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We are Not in Kansas Anymore:
Putting Alzheimer’s in Perspective
By Shelly Moss

(Page 2 of 2)

A more successful approach in dealing with Joe is to go into his reality.  If he gets up and is ready to go to his job as a mechanic, go with it.  Talk to him about his job, what he does, who he works with, and what he likes about it.  If he tries to leave his home or the facility, explain that his boss called and said they didn’t need him to come in today.  This explanation will make more sense to him than the truth of him not having worked in 10 years.

Let’s revisit Dorothy in Kansas, crying to her caregiver to go home. She is told repeatedly that she is home, and Dorothy retorts that she indeed is not. She and her caregiver are exasperated with one another and the exhausted caregiver places Dorothy in a nursing home. Dorothy continually cries that she wants to go home and the guilt-ridden caregiver takes her back to the old house. But still she says, “I want to go home.” What now?

The caregiver tries to tell Dorothy that she is old and frail and can no longer take care of herself.  But she cannot get through to her because in Dorothy’s mind, she is still skipping down the yellow brick road with Toto close behind.  If you want to relate to her, you had better start skipping. Talk about things in the past that she remembers—Auntie Em and Henry, or even mean Miss Gulch.  Let her tell you how much she misses them.  Bring food or fix things she enjoyed in her childhood.  Bring pictures from the old family scrapbook or picture books of that era. There are numerous books with vivid pictures of the Dust Bowl and the Depression, of the first Ford assembly lines and electric appliances. Let her be the expert on things of the past.  Encourage her to talk about what she did and what she was proud of.  Part of wanting to go home is a desire to go back to a time when we were young, vigorous, and productive; a time when we felt loved and needed.  Allow her to grieve for the loss of those times. Tell Dorothy she is still loved and help her feel needed. Let her know she is valued for her wisdom and her experiences.

There are days when ordinary, healthy people want things to be the way they used to be. There is no solution except to spend some time grieving the loss of these things. Children have grown and moved away, careers are over, and friends are gone.  People with dementia need the opportunity to grieve just as we all do; they just need more guidance. Affirm and validate their feelings of sadness.  Allow them to be sad.  Then do the best you can to make them comfortable in the here and now.  And if all else fails, try skipping.  It is very good for the heart!


Shelly Osborn Moss is the Executive Director at King’s Manor Methodist Home in Hereford, Texas where she has been employed for many years. She has worked with Alzheimer’s residents and leads Alzheimer’s and caregiver support groups.  She is married and has two children.


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