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When he doesn't articulate sensibly, I reply with anything that conveys absolute confidence and praise in him. For example I'd say how observant he is, or how I admire him for being so capable. "How did you manage to do that so well?" Or, "You joker. My sweet cookie you, you're so terrific". I never spoke like that before but he's a shaky child now.
Whatever, and I mean whatever, I say always trumps his initial confused thought because he can't remember what he's trying to convey. And he always makes a hair pin turn going with my reply or statement rather than his train of scrambled eggs.
Your plan of attack -
(Of course I'm being subjective. This is how I manage my husband).
Keep in mind that there are two fronts to deal with. Fractured thoughts, and the chemical reaction, (the message), that the confused thought sends to the body.
A strange thought may have triggered a feeling of fear, sadness or sense of loss that can't be identified or reasoned away.
And so you can try saying, "Oh, I'm glad you brought that up…"
["glad" translates to "good". She needs to hear or think "good". I did something good. I said something useful, so I'm good. (She still has an ego), as a result, we hope, she'll feel good. And then her thoughts will be all turned around, again hopefully, to What are we talking about?] and you continue with, "I would've forgotten otherwise. I meant to ask you if you had a preference for lunch".
Or, "Crazy as it sounds, I wanted to go to the bakery for a coffee and a Napoleon pastry. What do you think? We can bring it home if you'd rather."
Or, "Funny thing how that reminds me of a song you loved. What was the name of it? No matter, it'll come to me later. I'd love to play some easy listening, or soft rock music. Would you like a juice or split a peach with me?"
Or, "Hey, I'm sorry to interrupt, but before I forget, did I tell you that you look like a million bucks. Oh man, I just remembered it's the weekend. There's a game show I wanted to watch with you. I think it's called Cash Cab. George said it's great".
Improv baby. Amaze yourself.
I approach my husband as a dance partner from time to time and we fox trot, one of two dances he muscle remembers from our few Arthur Murray lessons 17 years ago. The monsters leave, he melts, and he doesn't feel so desperately alone in his skin. Alone. I think that's the most identifiable look on his face. That and the other heart-piercing expression, the searching look.
My husband recently started to talk to himself as well. He's picking at his fingers bloody again too. My thoughts are that I'm not keeping him busy enough. I can do but so much, and so yesterday he was registered to join a memory adult day care center for two days a week. It's not going to be easy for me financially or logistically. Up to 8 hours of care, (we'll probably do 6 to start) and a 45 minute drive to drop him off, but after all these years I'll take it.
Good luck to you.
When my mother with advanced dementia would insist on knowing where her mother was (her mother died 37 years prior), a few times I told her 'your mom is living in the Bahamas now b/c it's too cold in Colorado for such an old lady.' She threw me a sharp look and yelled I KNOW YOU'RE LYING, SO CUT IT OUT. So I had to come up with a more believable story about where her mother was and not treat her like she was an idiot, silly me. Lesson learned.
You have to come up with a believable story for your wife, whatever that may be, I can't tell you. Just as long as it's not a nonsensical story of some kind. When she's very persistent, that can be a sign of anxiety which means she may need a small dose of calming meds to help relax her, thereby diverting her attention from the subject that's driving her to distraction. Ativan .25 mgs helped my mother A LOT when she was insistent on finding her mother who she felt was 'hiding' from her at the Memory Care. No amount of 'diversion' was going to get her off the topic, so the meds did the trick. She was increased to .5 mgs as her agitation and anxiety increased. She wasn't zombied out..........just relaxed enough to be functional and not harping on where the dead relatives were at any given time.
If you are going to keep your wife at home & be her caregiver, I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.
The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2
She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”
https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4
The 36 Hour Day is another great reference type of book to get. Teepa Snow has some excellent videos on YouTube you can watch to learn how to best interact with your wife and enter HER world now that she's riddled with dementia.
Best of luck to you.
You can ask her questions (if they do not upset her) like:
How did you get there?
What are you doing?
What is the weather like?
Who are the people?
What do they do?
(this information might come in handy if she asks YOU questions about where and who.)
If she asks YOU about the people or place simply tell her that you forgot about it or you don't remember the people. If she insists then try changing the subject. Ask her if she wants a piece of fruit, a glass of iced tea, some water, go for a walk.....
Talking to herself I would not worry about. I do that a lot and if I had to worry about it I would not get anything done.
If this is upsetting to her at all discuss it with the doctor. There are medications that can be prescribed for anxiety.