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Saying goodbye after a visit with someone who has Alzheimer's


Question: We have a monthly Alzheimer's support group at our office. One of the ladies in our group is the caregiver for her husband who now lives in an assisted living facility. He has Alzheimer's and has a hard time when she leaves him to go back home. She said that she starts to remind him that she is leaving about 45 minutes before she actually leaves. And, of course, he gets upset after she is gone. Last month after she left, he packed his bags and called her from the nursing station to come back and get him! She asked if she is doing the wrong thing by telling him that she is leaving. On the other hand, she is dealing with so much guilt that she feels like she has to tell him to give herself peace of mind that she isn't hiding something from him. Can you help with some advice for this situation? Thanks so much.

Dr. Amy: It’s important to remember that as this disease progresses, people with Alzheimer’s disease have more and more difficulty processing events. Your friend’s husband may be in a different frame of mind each time she sees him. I suggest experimenting with different approaches to see which one works best. For example, your friend might try timing her visit so that she leaves just as a regular activity (such as lunch) is about to begin. In this scenario, she gives him no notice that she is leaving, but simply gives him a hug and says she’ll be back as soon as she can. If she is wearing an overcoat, it’s a good idea to hang that in another room, so there are no visual cues that she is leaving.  There is no reason to feel guilty for dealing with someone on their level. With young children we avoid confrontation and redirect their attention to get past a sticky point. That’s because their cognitive abilities are not fully developed. People with Alzheimer’s have had their cognitive abilities damaged by this terrible disease. It’s heartbreaking, but your friend’s husband is not the same man he was before we had Alzheimer’s. We create a happier experience for everyone when we keep emotional upset to a minimum. If this means being less clear about leaving after a visit, I think that’s just fine.

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