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
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
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
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
Sally Smith: No, no, no, no.
Fran Emerson: You know, don’t talk to strangers, and don’t take your
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
Fran Emerson: Yeah.
Sally Smith: Yeah.
Fran Emerson: And it’s
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.