The Five W’s of Dementia

By: Gary LeBlanc

Some of the more orthodox crime detective practices of solving a mystery, trained investigators are taught to always concentrate on asking the five W’s: who, what, when, where and why.

As a caregiver for someone living with dementia, you will soon discover that your daily routine involves the constant task of solving many mysteries, but, on the contrary, these are five words you will want to refrain from using at certain times when caring for someone who is suffering from a dementia-related disease or some other form of memory-impairment. This is due to the ever changing and evolving confusion associated with this disability.

For example, in my mother’s situation, late afternoon around 4:15 p.m., she would begin to show signs of Sundown Syndrome, also known as “Sundowners” which denotes an accelerated state of confusion. Knowing this, I would habitually avoid asking any questions that I knew would throw her deeper into a perplexed state.

Common sense should be telling you as a caregiver to back away from any questions which are incorporated with the five W’s.

• Who are you upset with?
• What would you like to eat?
• When are you going to wash up?
• Where do you think you’re going?
• Why are you crying?

There are many other letters in the alphabet besides W’s to worry about. The point being, when you see he or she is already having difficulties don’t begin making inquiries that you know probably won’t be able to be answered, likely causing further turmoil. Just use the five W’s as a rule of thumb to hold in abeyance in the back of your mind.

A good practice to follow as a caregiver is to keep a log or journal, recording the time of patients’ outbursts, mood-swings, sleep patterns or anything you think may be important. This will help you anticipate what their daily routine should be.

Remember, keeping a routine is the number one thing you can do for someone suffering from any form of memory-impairment. If you practice this rule, your caregiving campaign will become a little bit easier.

However, there is one “W” word I would like you to use. Try to stay in the habit of substituting the pronoun “we” for “you” when you see that the need is appropriate. By turning whatever you’re trying to achieve into teamwork, you will find that things will go a lot faster and more smoothly.

It may also help with activities such as attempting to get them into a bathroom or getting them ready for a doctor’s appointment. Always present the task as if you are going to do them as a team and that you need their help to get this accomplished.

Changing our daily vocabulary may be difficult at first, but with enough practice, it should become second nature.

Another important matter to address is to re-introduce ourselves every time engage this person. The memory of your last meeting may have evaporated as fast as breath on a bathroom mirror. Do not let them play a guessing game. By keeping them in the know, we will help keep their confusion down.

Remember this: To those with dementia, questions are the root of all evil. Limit the necessity of their having to determine who is who.

These suggestions may sound somewhat minor, but trust me; they can make a world of difference in keeping these loved ones calm and less confused.

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