Alzheimer’s Disease – Stealing, Rummaging, and Hoarding

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Transcript:

Sally Smith:  Welcome to Age to Age.  I’m Sally Smith.  Let’s talk.  Fran Emerson is with us today.  Fran is the Charleston area program director for the Alzheimer’s Association and has vast knowledge, and very practical knowledge, about Alzheimer’s, dementia, and related caregiving.  She has shared some amazing insights with us.  Fran, one of the things I love the most about the way you train people for caregiving is this wonderful attitude you have about looking at things in a different way.

 

One of the things that came to mind when I was speaking to you earlier was the memory of my mother.  She had lived a life where she did not, in any way, need to shoplift, or do anything like that, and was the loveliest lady you’d ever met.  On a few occasions, however, we’d she her slipping a little silver spoon, her own silver spoon, in her own house, into her pocket in sort of a clandestine way.  We just couldn’t understand what that meant.  It was her own house, her own spoon, but she would slip it into her pocket.  I notice that you have a different way of looking at some of these behaviors that make it more forgivable and easier to live with. 

 

I think you said that taking things is one of these behaviors that is common and has sort of a different origin in the mind of the person who has the dementia.  Could you tell us what this stealing is associated with?

 

Fran Emerson:  Yeah.  Okay.  Well, the first thing we’ve got to realize is that shoplifting or taking things, or stealing, requires quite a complex thought process.  You’ve got to plan it.  You’ve got to decide what you want to take.  You’ve got to execute it.  Now, someone with dementia does not have the ability to plan and execute such a complicated process as that.  So, if you see someone putting a silver spoon in their pocket, taking something off the shelf in a store and putting it in a bag, or going into another resident’s room and picking something up and taking it, they’re simply collecting things.  They’re simply shopping.  There’s no intent. 

 

One of the positive things about dementia is that any evil intent is simply not a possibility because that requires too much of a complicated thought process.  So, if someone’s doing something, they’re not being malicious, evil, or criminally minded.  They’re simply shopping.

 

Sally Smith:  They’re simply shopping.  And you had another wonderful thing about rummaging. 

 

Fran Emerson:  Rummaging, yes.  I mean, take our lives.  I’m getting up in the morning and I want to find an item of clothing, what do I do?  I open a drawer and rummage through and find it.  Rummaging is not something that’s peculiar to people with dementia.  We all do it.  We do it every day.  But, people with dementia can do it more.  It’s normal.  They’re sorting things.  They’re rummaging through belongings and sorting things.  It’s a simple activity.  It’s often a very meaningful activity, and a pleasurable activity.

 

Sally Smith:  And it’s another one of those examples of, so what?

 

Fran Emerson:  Yes.

 

Sally Smith:  So, rummage all day.  What about hoarding?

 

Fran Emerson:  Hoarding is a very interesting one.  Sometimes you’re in a restaurant and you see someone take a few of those little packets of sweetener, and that’s people without dementia.  It’s collecting.  People are collecting things.  When my family and I went to my mother’s flat, or apartment, in England, after she moved into a residential home, to clear her belongings, we found plastic bag after plastic bag, and papers bags, full of coins, hundreds of pounds, or dollars, worth of coins. 

 

My mother, obviously, had collected this over a period of time, for whatever reason.  And, you know, is it important what the reason is?  Probably not.  But she was hoarding this for a reason.  Perhaps she felt she needed to have money available.  You know, anybody brought up in the Depression, or during wartime…

 

Sally Smith:  Good point. 

 

Fran Emerson:  So, she needed to collect that.

 

Sally Smith:  I know that well.  I do think that people who went through the War, certainly my parents, my mother, and the Depression were vaccinated for life with the feeling of making sure you had enough for the rainy day.  There was this sense of saving things.  I will say, one lovely thing about my mother, she used to say, in her wise days, you children tease me about my saving these things, but anytime you need something, you come to me, and I’ll say, oh, I think we have one of those; I think we can get you that, then you’re thrilled. 

 

What about this wonderful term, eloping?

 

Fran Emerson:  Oh, eloping.  You know, as a person from England, I always get a kick of this because when I first came to this country, twelve years ago, and was associated with dementia-specific facilities, I was actually a marketing person.  The administrator came into my office one day, quite agitated, and said, Mrs. So-and-so has eloped.  You know, to me, eloping is someone going to Gretna Green in Scotland.

 

Sally Smith:  Exactly, to get married.

 

Fran Emerson.  To get married, without the permission of their parents.  So, I got a big kick out of that.  So, elopement?  So, someone has left the building, like Elvis; Elvis has left the building.  So, do we say that people have eloped, except in a facility setting where someone has left the building and you don’t where they are?  It may be a secure facility and they’ve followed someone out the door, a visitor, and they have eloped.

 

Now, the person with dementia isn’t eloping.  They’re not going to go and get married, and they’re not, necessarily, intentionally escaping a situation because they can’t work it out.  They’re going somewhere.  They’re probably going home, a home that existed some time ago, maybe in their teens, their childhood; they’re going home.

 

Sally Smith:  I had a friend who had a wonderful solution.  Of course, we all know, this is a freefall and everybody comes up with their own solutions that happen to work for that parent, or loved one.  But, this person always wanted to go home and they would come in front of the child and say, I want to go home, I want to go home.  And, of course, the child tried certain strategies, none of which seemed to change the desire to go home.  Finally, she said, well, great, let’s get in the car and go home.  She’d put her in the car, drive around the neighborhood for, you know, blocks.

 

Fran Emerson.  Sure.

 

Sally Smith:  Or ten minutes, whatever it took, and go back, get out of the car and go in.  It was completely over.  So, she got the feeling that she went home.  It assuaged her anxiety.

 

One thing, a different way of looking at resistance to care, I’ve met with resistance to care, you say that feeling uncomfortable is often, really, what’s happening there.  Is that like, I don’t want to take my sweater off and get in the bathtub?  How does that play out?

 

Fran Emerson:  Right.  You’ll often hear staff in a facility say, you know, Mrs. So-and-so wouldn’t take a bath today.  She wouldn’t get in the shower for me; she wouldn’t do this.  And they write on her chart, Resisted care.  One of the places where catastrophic reactions, or behaviors, can occur most commonly is in a bathing situation, in a facility.  You’ve got to think about this.  We’re asking someone in their eighties, who is not sure where they or who they are, to take off their clothes in front of a stranger in, probably, the coldest room in the facility and get under, or in, water.  And we are somehow surprised that this results in some anxious behavior. 

 

You’ve got to think about their comfort level.  Now, if you’re cold, you’re uncomfortable, and if someone is trying to bathe you, or shower you, it’s an uncomfortable situation.  Similarly, if someone is trying to help you get dressed, one of the things we’ve got to remember is, as you age anyway, your skin sensitivity is much greater than when you were younger.  So, you’ve got skin sensitivity.  You’ve got someone approaching you in your space, trying to put on or take clothes off.

 

Sally Smith:  And you’re naked.  You’re exposed of what you’ve been taught to keep away from people.

 

Fran Emerson:  Exactly.  What did your mother tell you when you were a child? 

 

Sally Smith:  No, no, no, no.

 

Fran Emerson:  You know, don’t talk to strangers, and don’t take your clothes off. 

 

Sally Smith:  The two things, and then a stranger comes in and tells you to take off your clothes, and you’re supposed to say, oh, that’d be great. 

 

Fran Emerson:  Yeah.

 

Sally Smith:  Yeah.

 

Fran Emerson:  And it’s uncomfortable.

 

Sally Smith:  Sure.

 

Fran Emerson:  The other thing is, no tight clothes.

 

Sally Smith:  Mm hmm.

 

Fran Emerson:  Tight clothes, for a person with dementia, what’s the first thing they’ll want to do?

 

Sally Smith:  Take it off.

 

Fran Emerson:  Take it off.

 

Sally Smith:  Yes.  You have such practical knowledge.  I love it.  And you have such a great attitude about the way to see things and to have, as you said earlier, a new relationship with this person, where you look at them from a different perspective.  You have a new relationship with them.  It’s not necessarily so sad.  It’s just practical in what needs to happen. 

 

Thank you, Fran, so much, for talking with us about that.  Thanks to all our listeners too for joining us.  We welcome your suggestions and comments.  This is Sally Smith, Age to Age, saying good-bye, wishing you courage and joy on your own journey.  We are all connected. 

 

If you enjoy listening to Sally Smith, you can buy her book, The Circle.  It’s the story of how she personally responded to her mother’s journey with Alzheimer’s disease.  It’s a wonderful gift of hope for anyone with a parent with dementia.  Just click on Sally Smith’s name under the Health Professionals tab on the Podcast home page.  All profits support research at the Center on Aging.  Thanks.


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