What is ‘truth’ anyway? It may be beneficial to have a look at what ‘truth’ as a concept is in order to better understand the role of ‘truth’ within the lives of people with forms of Dementia. So what is ‘truth’ anyway? For a long time civilizations thought the Earth to be flat, and punished anyone who would challenge this ‘truth’. And for a while, scientists said that the ‘truth’ was that atoms were the building blocks of the universe and the smallest forms of existence. And in the past, only boats made from wood were known to float, this ‘truth’ was perhaps inspired by observing the way driftwood stays afloat.

In all three these examples, we have demonstrated the temporary nature of what we identify in a given moment as ‘truth’. In that moment, it was their ‘truth’ and anything else was looked upon with instant dismay. We now know; the Earth to be spherical, for there to be a whole soup of observable matter smaller than an atom and for there to be a large variety of materials with which one can build a boat that will float. The ‘truths’ of these three examples have transformed with time from generation to generation.

The mysterious mind of Einstein has provided us with a theory which most of humanity accepts as ‘truth’; the theory of relativity. We can harness his theory and the implications thereof and say that ‘truth,’ like time, is relative within the eyes of the beholder. If we were to visit one of the tribes in the Amazon, untouched by all outside influence, their perspective of ‘truth’ will be worlds apart from yours and mine. To them, the ‘truth’ is that they live in the forest, which they do not call the Amazon. They hunt animals and gather from nature as a source of food. This is their ‘truth’. If you were to try explain a McDonald’s to them, they’ll think you’re a loony. Is it ‘true’ that there are thousands of McDonald’s around the world serving fast food? Yes. Is it ‘true’ to the tribe? No. That’s because ‘truth’ is relative.

But the grass is green! This is an unquestionable ‘truth’ that cannot be falsified! Well actually, the grass is green to us. For cattle, who spend their lifetimes eating grass, the grass isn’t green at all but rather different shades of black and grey because they’re red/green colorblind.

So here we are, relatively speaking, at a point in this one-way discussion where we start linking all these truths to the care of people with forms of Dementia. As we walk into the Jura Care Village, we may find many different realities, that is to say that what is ‘real’ and ‘truth’ to one resident is not ‘real’ or ‘true’ to another. Let’s take one resident as an example; through intimate care and close observation we have come to realize that she shifts from one ‘reality’ or ‘truth’ to another, depending on which memories are active within her mind.

One moment of the day she will be a little girl, this is because at that moment she remembers being a little girl. All other memories of her being a woman, or a grandmother, are either inactive or unavailable at that time. And so she asks for her mother, tells endless stories about her current childhood and needs to be tucked in at night because she thinks she is a little girl. That’s HER ‘truth’. Then at other times, especially when she sees a man, her ‘truth’ shifts into being a young woman filled with bubbling libido. She lights up, dances and flirts. Gone are the memories of being a little girl. Her ‘truth’ now is that she is a young, irresistibly attractive lady. And then still at other times, but far less occurent, she remembers she is an old woman and acts accordingly.

And so once again, we have given three examples, three ‘truths’, three ‘realities’ that are relatively ‘true’ for her at any given time. A whole book can be written on the subject, but for now lets examine where that leaves us; the caregiver. What do you do about these uncanny ‘truths?’ Do you impose your relative ‘truth’ on her? Do you tell her she is demented? That she is hallucinating? That she isn’t a little girl but an old woman? Do you put her infront of a mirror and say; “Look!” You can do all of these things, but the outcome won’t be what you may have expected. This is because she no longer has the cognitive reasoning ability we take for granted. She can’t make sense of your ‘reality’, of your ‘truth,’ and that which you are trying to show or tell her. If she stands before a mirror and you say: “There, you see, you have grey hair.” She might be momentarily captivated by her hair which you pointed out, but because the mental illness has reached such a devastating stage, there will be no connections made within her mind between grey hair and age. Her daughter or son can be standing right before her, living testament as to her age, but she will still continue living her relative ‘truth’ of being a little girl.

Thus as caregivers, we need to completely forget the whole notion of what we perceive to be ‘true’ and focus on that which is transparently clear: she has a mental illness and if we want to care for her, then we have no choice but to step into HER ‘reality’ and accept HER ‘truth.’ We need to adjust ourselves and adapt to what she believes is ‘true.’ If she’s rubbing her hand in a circular motion on a table, think to yourself: ‘Could she be washing the table in her ‘reality?” Grab a cloth and join her. DON’T force the cloth into her hands and say: “There, now you have a cloth, good job.” Believe it or not, but she was already washing the table before you came along. Just because you didn’t see the cloth under her hand doesn’t mean it wasn’t there. Instead, join her by washing the table and if she notices that you have a cloth and would like one too, then that’s great. If not, then that’s great too! We, as caregivers need to be constantly reminded that it’s not about you and me, it’s about them.

We must be able to clearly understand the difference between contradiction and concurrence. As soon as we force our ‘truth’, ‘reality’ or opinion onto her, we are contradicting her ‘truth’, ‘reality’ or opinion. As soon as we hand her a cloth without her recognizing and wanting the cloth, we are contradicting her ‘truth.’ If a resident wanders aimlessly with his ‘truth’ being that he is searching for his home. By telling him that he doesn’t have a home, or that he is home or that he cannot go home, you are contradicting his ‘reality,’ and are likely to generate aggression, irritation and/or hostility. Instead, you should concur with his ‘reality’ by helping him to a destination. As soon as he knows he is on his way to a destination, his anxiety will lessen or vanish. You do not contradict him by commenting on the validity of his ‘truth,’ instead you aim to distract him by looking at the birds, talking about his life and that which is relevant to him in that moment. It all boils down to this: If you want to truly care for people with Alzheimer’s and other forms of Dementia, you must concur, not conquer!